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ALL APPLICABLE NF • MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: Permit Number:
45tiayr
• Building Permit Application iO�147 c gs
Planning and Development Services St. Luce_ L Luray, FL
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION;,
Address: 595 Nettles Blvd. Jensen Beach FL 34957
Legal Description: Nettles Island Inc a condo- Section II Parcel 595
Property Tax ID #: 4502-501-0781-000-9
Site Plan Name:
Project Name:
Lot No. 595
Block No.
Setbacks Front 10 Back: 5 Right Side: 0 Left Side: 8
DETAILED DESCRIPTION OF WORK:
construction of single family home ,> X. r--l'
CONSTRUCTION INF,ORMATION
Additional work to e e orme under this permit — c ec a apply:
WIHVAC Ei Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
R1Electric ❑✓_ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor: np
Cost of Construction: $ ry Utilities:Cn Sewer U Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Richard and Janet McGillis
Name: James Newman
Address: 27 Floyd Wycoff Drive
City: Morganville State: L,5
Zip Code: 07751 Fax:
Phone No.732-972-7515
Company: JWN Construction, Inc.
Address: 1701 SE Carvalho Street
City: Port St Lucie State:�`--
Zip Code: 34953 Fax: 871-9500
Phone No. 772-201-8947
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: jwnconstruction@comcast.net
State or County License: CRC1328282
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
tlSUiPPLEMENTAL CONSTRUCTION
. ,
' h
LIEN LAUVANFORMATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Quantum Engineering Associates, Inc
Name:
Address: 300 Avenue of Champions
Address:
City: State:
City: Palm Beach Gardens State: FL
Zip: 33415 Phone: 561-202-6994
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencinE work or recordine vour Notice of Commencement/1
Signature of Owner/Agent/ Lessee
re of Contractor/License Holder
STATE OF FLORlrkA, ST$rE OF FLORI
COUNTY OF COUNTY OF
The forgoing instrun ent was acknowledged before me The forgoing instrur9ent was pcknowleidged before me
this _-- day of 20 1'L by this :� day of r yi —20_1_44by
i
(Name Overson acknowledging) (Name of Arson acknowledging )
re of Notary Public- State of Florida )
Personally Know ication
Type of Id n R. Prof�p�K.NEWMAN '
F*q' MY COMMISSION # hi: Mulu
`* EXPIRES: April 20, 201.7
Commissl :o: mruNetwPub2CO de
Revised 07/15/2014
of Notary Public- Stalte of Florida )
Personally Known Produced Identification
Type of Identification Produced
EW
Commission No. �'? '=_ YCOMMSSImR9WWO
sti : a EXPIRES: April 20, 2017
Bonded Thru Notary Public UnderwAGre
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