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OFFICE USE ONL • -
DATE FILED: /l
PLAN REVIEW FE RECEIPT N(Y%!1a Q y PERMIT NUMBERy D
CONCURRENCY FEE: n •• tYI RECEIPT NO.: CERT. CAP. NO.:
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
,COUNTYBUILDING & CODE REGULATIONS DIVISION )Z" J �
2300 Virginia Avenue
,.,_„ Ft. Pierce, FL 34982-5652 L
772462-1553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAPACITY/ZONING COMPLIANCE
PROJECT INFORMATION
1. LOCATION/SITE ADDRESS:g9 Z Ne,+HCS 131 A 'JcftY�n EnocL� q ��- -- �
2. PROJECT NAME: QMns SITE PLAN NAME:
3. PROPERTY TAX ID # -" Jc I - I ( I C1 3
4. LEGAL DESCRIPTION (attach extra sheets if necessary): k5 (s Lard ) W, . A (nr d o -
S�� ftca� 11 orce l 942 and afro-tGtQ rn om >n c-]ements 1A4
5. PLAT BOOK 6. PAGE NO. 7. BLOCK NO. 8. LOT NO, q 9 Z
1
9. PARCEL SIZE (ACRES/SQ FT.)Ca . GE LOT DIMENSIONS l �
az-
10. COMPLETE DESCRIPTION OF CONSTRUCT ON(PROJECT OR WORK ACTIVITY•
Res- � oV Z O 1 � Yln CA3 �`� b ) VK G. w
' (V-c vv o ry r- s c�Yz yC- `�3 S 7
1 I . SETBACKS (ACTUAL) FRONT: % BACK: RIGHT SIDE: 40'- !i 1 % LEFT SIDE: D
0•rJ
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
XNEW CONSTRUCTION [ ] EXPANSION/ADDITION [ ] INTERIOR RENOVATION
(] RESIDENTIAL [ ] COMMERCIAL (] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: I )OA 1 HL)M P
q�J
16. VALUE OF CONSTRUCTION: $ % <%r e
The value of construction is used to determine the amount of permit fees to be assessed. St. Lucie County reserves the right to question and/or modify the indicated
value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction activities. If the value is $2500 or more, a
RECORDED Notice ofCommencement must be submitted with this application.
SLCCDV Form No.: 001-02
UPDATED 6/25/09
OWNER INFORMATION
NAME
ADDRESS: -i" -tV (-01o►-na AA V% 11_ gt5 /� 1
CITY: Gar) 114go STATE: 0, A ZIP -
PHONE (DAYTIME): (M -2 rjc-S fl Email: &±bbp0 V(] �'X) - ro
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER-
TTE� OWND ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER:
ADDRESS:
CITY:
PHONE (DAYTIME):
CONTRACTOR INFORMATION
STATE:
Wo
ST. of FL REG.CERT #: ST. LUCIE COUNTY CERT #:
BUSINESS NAME: .'V ed - Onmfrvdiba inc,
QUALIFIERS NAME: Ma ,K
ADDRESS: 11A ID-3 S. UCenn Dri
CITY:c )P,nf:0q Rwch STATE: �� ZIP: 6qq5 T
PHONE (DAYTIME): Cz2zq zq3 FAX NO.11Z ZZ 9_-WEmail: Mach i eV , CdM
W `
ARCMT/ENGINEER. --� c� vl/ �r LL � 1 Ena I rzcrs and Cdr-s+rUG+nr-5411ic/
T�Apiflrbw
1 = , i
BONDING COMPANY:
ADDRESS:
CITY:
MORTGAGE LENDER
ADDRESS:
CITY:
STATE:
STATE:
STATE:
ZIP: 3 LA qq-+
ZIP:
ZIP:
IMPORTANT NOTICE: When a permit is issued and it is not picked up within 06 days after notification
it will be voided and returned to you by mail.
N
CERTIFICATION:
This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity,
if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS,
AND AIR CONDITIONERS, FENCES, ETC., not otherwise included with this building permit application.
St. Lucie County makes no representation that its granting of a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants that may restrict or prohibit such
structure. Please consult with your Homeowner's Association and review your deed far any restrictions which may apply.
The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory
structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non-
residential use.
NOTICE TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSTTE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO
ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN
GOOD FAITH TO DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO
THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT.
OWNER OR CONTRACTOR SIGNATURE
STATE OF FLORID
COUNTY OF IQJ
The foregoing instrument was acknowledged before
me this __q_ day of Sr, 20J3___,
who is personally known or has produced
as identification.
Signature of Notary
Commission No. ;°eL VI N. KNEPPER
.: sion ADD 995518
W. or Expires September 25, 2014
Baled TMu Troy Fain ft ranw 80MW7018
CONTRACTOR SIGNATURE
STATE OF FLORIDA
COUNTY OF PK a ,C
The foregoing instrument was acknowledged before
me this day of , 20_�) ,
byCh
who is personally known or has produced
as identification.
_L1 ' / - .
Signat -e arbAVID
N. KNE �'• `�'
.` Commission #+DD 99551$
Commi Expires Se t( tarn 25 l
a Baled T'Mu Troy Fan Insuranp 800-3857019
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN
THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS.
For specific instructions see appropriate permit checklist.
'
-+
OFFICE USE ONLY9 P 7-00
SECTION
TOWNSHIP
RANGE
MAP NO.
FZONING
r (�
LAND USE
LOT CVG %
TAZ NO.
FLOOD ZONE
C
FIRM MAP #
`�
I ST FLR ELV
MAX HGT
CONST TYPE
OCCUP TYPE
MAX OCCUP
# OF FL S
WATER
SEWER
SPRINKLERS
STORMWATER
LOT OF REC
LOT OF REC
LOT SPLIT
LOT SPLIT
Before 1/1990
After 1/1990
REQUIRED
APPROVED
REPORT
HABITABLE
RADON
PERMIT
CODE
AREA
FEE
FEE
LIBRARY
PUBLIC BLD
C BLD
PARKS
IMPACT
MACT FEE
_
IM[PACT
MACT
FEE
CORRECTION
FEE
FEE
GENERAL
SCHOOL
ROAD
CREDIT
Y
N
LAW ENF
MACT
IMPACT
IMPACT
FEE
FEE
FEE
FIItE/EMS
DRIVEWAY
Y
N
DRIVEWAY
ADMINISTRATIVE
IMPACT
REQUIRED
FEE
VARIANCE FEE
FEE
SPECIFY
MECHANIC ROOF`'
NON -CONFORMING
MISCELLANEOUS
SUBS
ELECTRIC GAS
LOT OF RECORD
FEES
REQUIRED
PLUMBING
FEES
DATE SENT TO ADDRESSING:
REVIEWS
I FRONT
COUNTER
I ZONING
icE-vinvV
I SUPERVISOR
F.E' -W
I PLANS
REVIEW
I VEGETATION
REVIEW
I SEA TURTLE
REVIEW
I MANGROVE II
I RF�Ti W
DATE
Ir
I i 1 ._
1
lb-1ko
I
-_--
INITIALS
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 3876120 OR BOOK 99 PAGE 618, Recorded 09/16/2013 at 54 AM
NOTICE OF COMMENCEMENT RFCE, QED SEP
Permit No. Tax Folio No. 7-� SVJ JI / ! -POO - � �Qu
State of Florida County of St. Lucie
The undersigned hereby gives notice that Improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes,
the following information is provided in this Notice of Commencement.
�T-
General description of Improvement: {ZtYY)W O)y? W-A1`-CVL a rbt9) d IV Yt/
C13 S-}oY�'C
Owner I p°l
bLLessee Information If the cawacted for the Improvement:
Name + Ys'� WfY
Address !S1rvC,SCtI✓ -CR
Interest in property: Y`r eW
Name and address of fee simple titleholder (if different from Owner listed above):
Contractofs Name: GC
Contractor Address: )afL"
Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $
Name and address:
Lender Name: �, Phone Number: _
Lender's address:
Phone Number:
number:
I-P,e,rson1s,within the State of Florida designated by Owner upon whom notices or other documents may be served as Provided by Section
L>�1•) (3)7., Florida Statutes:
Name: Phone Number.
Address:
In addition to himself or herself, Owner desi pates
Lienor's Notice as provided in Sectb 713.1 ) (b), Florida Statutes.
Phone number of person or entity designated by owner:
to receive a copy of the
Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the
contractor, but will be 1 yearfrom the date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED
IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
RECORDING YOUR NOTICE OF COMMENCEMENT.
Under penalty of pedury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of
my knowledge and belief.
L21-jAJ
(Signature of owner or Lessee, or Owners or Lessee's Authorized Officer/Director/Partner/Manager
(Signatory's Title/Office) Z
V
The foregoing instrument was acknowledged before fine thls� day oi,t , 20 1 �!
BY e as im+ "t-c for
Party oIf of whom Instrument was executed
DAVID N. KNEPPER \V
• Comntsion fCDD 9Wl8 Personally known_ or produced Identification_
(Signature of Notary Public State lorida fi Expires SO Mber ro4t
(Print, Type, or Stamp Commissioned Name of Type of Identification produced
STATE Of FLORISA
ST. LUCIE COUNTY
THIS IS TO CERTIFY THATTHIS IS A
TRLP AND CORRECT COPY OF THE
ORIGINAL I
--1P U i E. S IayR H, r✓ L %i K
/ - D8P*V C; rk—&-% .
Date: $EP 1 RJR
oC1_ d�� •
SEP
COUNTY16,E
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
BUILDING & CODE REGULATIONS DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LANDS AFFIDAVIT
I, the undersigned, am the owner of the following described property,
y >oA - moo) - W7 9 - oo 0- 3 j
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Development Permit. In
accepting this Final Development Permit, BP Number , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community W I L L N 0 T be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
C�i 6i AM1ES
Property Owner Name'(Please Print)
Propeoy Owner Signature
STATE OF FLORIDA, COUNTY OF �� L�,
C % Q-
Date
ACKNOWLEDGED BEFORE ME THIS I `�' _.,.,,... DAY OF 20 '� _✓ �,
BY IJe/ WHO IS PERSONALLY KNOWN TO ME _ OR WHO HAS
AS IDENTIFICATION.
OF NOTARYIPUBIld OR PRINT NOTARY
COMMISSION NUMBER
DAVID N. KNEPPE )
ACommission fDD
- PI Expires September 25, 2014
Baled Thm Tmy Fan insunuce BW3857019
SLCPDSD Revised 08n4n010
0
Nettles Island Inc.
August 6, 2013
Mrs. Eames
992 Nettles Blvd
Jensen Beach, Fl 34957
RE: 992 Nettles Blvd
L
a condominium
9801 South Ocean Drive, Jensen Beach, FL 34957
(772) 229-2930
FAX (772) 229-9901
Nettles Island Inc. has no objection to the house plans as submitted, drawn by Mel-Ry
Construction Inc.
Respectfully,
William Harkins
Operations Manager
Tom Bellavance
Architectural Committee
Cc: Joan Thayer, LCAM, File
•
6EDEI V
0*0 `D SEp 16ft
EL-RY CONSTRUCTION INC.
low RESIDENTIAL K; COMMERCIAL BUILDERS
AGREEMENT FOR DEMOLITION OF STRUCTRE(S) LOCATED AT
992 Nettles Blvd Jensen Beach, FL 34957
PI D# 4502-501-1179-000-3 Nettles Island Inc. Lot 992
Owners: Beth Eames
The above referenced owners have given MEL-RY CONSTRUCTION, INC. the
approval to demolish the above described property.
Date
Mel-Ry Construction, Inc.
10967 S Ocean Drive
Jensen Beach, FL 34957
772-229-9439 Office — 772-229-9440 Fax