HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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--�= building Permit Application
Planning and Development Services Public Works
Building and Code Regulation Division
St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR• u3j_ ngl!
PROPOSED IMPROVEMENT LOCATION:
Address: 1308 NETTLES BLVD, JENSEN BEACG, FL 34957
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1308 AND PRO-RATA SHARE IN COMMON ELEMENTS (OR 3827-1020)
Property Tax ID #: 4502-501-1495-000-4
Site Plan -Name:
Project Name:
Setbacks Front 10' Back: 5' Right Side: 6" Left Side: 8'-0"
DETAILED DESCRIPTION OF WORK:
�iUILD NEW CBS 1 1/2 STORY HOME ON HELICAL (PIERS
Lot No.
Block No.
CONSTRUCTION INFORMATION:
AdditionaiworKtobenertormedunder this permit— check all tha apply:
�HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers 0 Generator W1 Roof
Total Sq. Ft of ConstructiorY�
Cost of Construction: $ 199,000
qu
S . Ft. of First Floori4*t_�
Utilities: LJ Sewer 0 Septic Building Height-
OWNER/LESSEE:
CONTRACTOR:
Name Andrew & LILY Litynskyj
Name: MACK MATOS
Address: 6109 Windemere'LN
Company: MEL-RY CONSTRUCTION
Address: 10967 S OCEAN DRIVE
City: Shelby Township, MI 48316 State: MI
Zip Code: 48316 Fax:
City: JENSEN BEACH State: FL
Phone No. 772-229-0012
Zip Code: 34957 Fax: 229-9440
Phone No. 229-9439
E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail: MACK@MEL-RY.COM
rom the Owner listed above)
State or County License: 23630
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Jame: HARVEY E. KOEHNEN PE# 32831
Name:
Address:
.address: 7205 ELYSE CIRCLE
City: State:
City: PSL State: FL
Zip: 34952 Phone: 772-488-5509
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
commencing work or recording our Notice of Commencement.
_- --
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Signature of 4trictor/License Holder
Si na ur _., -Owner/ ee/Ag nt P
STATE OF FLORID` L1t��
STATE OF FLORIDA� '
COUNTY OF
COUNTY OF
The for oing instry�►� t w, acknowledged before me
`'t
The rgoing instru ent was acknowledged before me
t
thisday of /"` 20t�by
this day of 201(�, by
0,4nr Y
(Name of p on ackno ledging ' .3,,(Name;ofp�rson
ac nowledging )
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(Signature of Notary Public- State of Florida)
(Signature of No ry Public- State of Florida-)
Personally Kno CMtRffJ0ftWWtfAfIfrfti0
ANGELA M HUFF
Personally Known cegoW06flatiffihtR of Flnrlda
�•
Ic tp3 o u{istine Matos
Identif 4730
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Commission No.
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P Y
d� �c1n' No. fill Bonde(fimliih National Notary Assn.
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Revised 07/15/2014
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