HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: New Construction
PROPOSED IMPROVEMENT LOCATION:
Address: 64 Nettles Blvd Jensen Beach FL 34957
Property Tax lD#: 4502-501-0250-000-8 Lot No.64
Block No.
Site Plan Name:
Project Name:
[DETAILED DESCRIPTION OF WORK:
Construction of 3 bedroom 4 bath all impact openings 2 story home
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: 2946 Sq. Ft.of First Floor: 1127
Cost of Construction: $ 450,000.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jeffrey&Luisa DuhamO Name:James Newman
Address:
103 Brown St. Company:JWN Builders, LLC
City:
Barrie ON State:_ Address:1701 SE Carvalho St.
Zip Code:
L4N7V6 Canada Fax: City: Port St_ Lucie State:FL
Phone Na.
705-561-2190 Zip Code: 34983 fax: 772-871-9500
E-Mail:
Phone No 772-871-9500
Fill in fee simple Title Holder on next page (if different E-Mail jwnconstruction@comcast.net
from the Owner listed above)
State or County License CRC1328282
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
if value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name:QEA Name:
Address:6415 Lake worth Rd.#185 Address:
City: Greenacres _ _State: FL City: State:
Zip: 33463 Phone 772-285-3216 Zip: Phone-
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:_ - - - -
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residential use
"WARNING 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU IV
END TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO CE OF COMMENCEMENT."
S nature of Owner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORI STATE FLORRA
COUNTY OF C '_ COUN OF
The forgoing instrL ment was acknowledged before me The=fgxgoing instr en was acknowledged before me
this day af�� T � ,20�( by thi day of 2(} by
Name of perso making statement. Name of person making statement.
1� AH
Personally Known OR Prod uc0t! 1f1 Personally Known OR Produ``ede5l�iti aR���ryT
Type of identification `\����+ •.• M!(�,������ Type of identification Bye •.•
Produced � F��. Produced •.�y �o�,
4 •c, ,4 p;•, z ;
r f c� � • z- ,/.�J� � 7f4�H 180t80
(Sig tore of Notary Public 5ta 'Mori a (Sig ature of Notary Public-State of 7 a• ain I„soc�°°••
r9,p•:of,Fsd®dsy18.�°�0���
Commission No. �y Sa�I :.•• ��� Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.