HomeMy WebLinkAboutBuilding Permit ApplicationPERMITAPPLICAT[ ON:FOR:.repalrexisting dock
PROPOSED IMPROV,EIVI'ENT LOCATION
Address::169 Nettles Blvd je,nsen beach, FI 34957:
Property Tax ID #:.4502-501-0355-00-4...: Lot. No:.
Site Plan:Name: nettles island Block IVo.
Project Name; rowe resd:
.. ..
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repair existing dock with new:materials
New Electrical Meter' S"etdhd:Efiktrical Meter
CONSTRUCI"ION INFORMATION
Additional work to be p' ncler this permit — check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric ' _Plumbing _Sprinklers _'Generator Roof : Pitch
Total Sq. Ft of Construction: .. Sq. Ft. of First Floor: '
Cost of Construction: $ 6,800.00 Utilities; - _ Sewer -_ Septic. Building Height:
01NN;ER/LESSEE"'CONTRACTOR
-�'
Name JANE ROWE
MICHAEL GUIDICE
Name: .
Address:169 NETTLE BLVD
City: JENSEN BEACH FL.., State:
Zip Code:-34957 Fax:
Phone No.
Company: TREASURE COAST BARGE' INC.
Address:1200.SE DIXIE CUT OFF RD.
City: STUART State.'FL
P 34994 :. ... .
Zi Code: Fax:
772 220-3625.
Phone .No.. - - "
'E.-Mail: .- � - �
Fill in- fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail TREASURECOASTBARGE@YAHOO:COM
State -or County Lcense20077
wi
If value of construction is md.o'r more, a RECORDED Notice of Commencement;is required.
If value of:HAVC is $7,500 or more, a;RECORDED Notice; of Commencement is required.
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SUPPLEMENTAL'CONSTRUCTION LIEN LAW,INF,ORMATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: —Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
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, walls, 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording vour Notiae-of Commencement.
re of Owner/ Lessee/Contractor as Agent for Owner 16ignature of ContractorTUcense Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF
j
(or affirmed) and subscribed before me of
hysical Presence or Online Notarization
a day of Aglr Ci 202) by
of person making statement.
nally Known OR Produced Identification
of Identification
ature-6fNota-r,y Public- State of Florida )
n No.I`Itt Q,f(oaP,-5, (Seal)
REVIEWS
RECEIVED
DATE
COMPLETED
Sworn to (or affirmed) and subscribed before me of
✓hysical Presence or Online Notarization
this io day of &r,, c F 2020( by
Name of person making statement.
Personally Known V OR Produced Identification
Type of Identification [A^
Produced,
c.
(Signature of Notary Public- State of Florida ) R 9 1 o
Commission No. O 86-? (Seal)
FRONT I ZONING SUPERVISOR I PLANS I VEGETATION SEA TURTLE I MANGROVE
COUNTER REVIEW REVIEW I REVIEW I RE I REVIEW REVIEW