HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED,
Date: Permit Number
RECEIVED JUN 13 2017
Building Permit Application
�10G-�3aA(3
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 APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 105NETTLES BLVD
Legal Description:
NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1055 AND PRO-RATA SHARE IN COMMON ELEMENTS (OR 843-514: 1052-204 : 1903-1156)
Property Tax ID #: 4502-501-1241! 000 —9 Lot No.105 -
Site Plan Name:
Project Name: MARTIN DOCK REPAIR
Setbacks Front . Back: Right Side: Left Side:
[DET'AILEb'DESCRIPTION'l'O'F'
WORK:
REPLACE AN EXISTING DOCK IN SAME LOCATION
Block No.
CONSTRUCTION] N FORMATION:
Additional work to be nartormed under tis permit —check all apply:
❑HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction:
Cost of Construction: $
S Ft. of First Floor: _
Utilities: Sewer ❑ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name SHAWN MARTIN
Name: --=-__f)
Address:1064NETTLES BLVD
Company: TREASURE COAST BARGE INC
City: JENSEN BEACH State: FL
Address: 1200 SE CUTOFF ROAD
Zip Code: 34957 Fax:
City: STUART State. FL
Phone No.330-283-3232
Zip Code: 34994 Fax: (772)221-1611
E-Mail: smartin@wmartin.com
Phone No. (772)201-9777
Fill in fee simple Title Holder on next page ( if different
E-Mail: JERNER@BELLSOUTH.NET
from the Owner listed above)
State or County License: 20077
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
Name: PAUL WELCH
Name:
Address: 1984 SW BILTMORE ST#114
Address:
City: PORT ST LUCIE State: FL
City: State:
Zip: 34984 Phone: (772)785-9e88
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
City:
Address:
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
improveme is to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the f st inspection. If you intend to obtain financing, consult with lender or an attorney before
commemin 1work or recording your Notice of Commencement. A
Signature of
re of
STATE OF STATE OF FLORIDA
COUNTY OFCOUNTY OFrIIII
The for oing instrument was acknowledged before me The f n instr Trent as acknowledged fore me
this 4r day of 20 T by this day of 20y
f
A �(YY)►Lho 1 0�
(Name of person acknowledging) (Nam f person Pn
(Signature Notary Pub] - State of-Ftc;rfcM-
OR Produced Identification
Type
MOLLY A.
Revised 07/15/2014
State of
(Signature of Notary Public- ate �f�lorida)Vio
v
Per�sv\onally Known OR Produced Identifi
Type of Identificat' d
Notary Public State of Florida'-.
Commission No. Luciforo
My C mmission FF 079827
of Fti Expires 12/29/2017 u
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS