HomeMy WebLinkAboutBuilding Permit Application1 �+
ak
Ww
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a\5 Permit Number: �S�S�b35
RECEIVED MAY 29 2015
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 APPLICATION FOR: Building
PROPOSED IMPROVEMENT LOCATION:
Address: 868 Nettles Blvd. Jensen Beach, FL 34957
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 868-ANDPRO-RATA SHARE IN COMMON ELEMENTS (OR 3609-2334)
Property Tax ID #: 4502-501-1054-000-1
Site Plan Name: Morren Residence
Project Name: Morren Residence
Setbacks Front /� Back: X ,
DETAILED DESCRIPTION OF WORK:
Right Side: S / Left Side: 9
New construction single family residence.
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to jeer orme under this permit = check a apply:
Z✓ HVAC L__J Gas Tank Gas Piping _ Shutters Windows/Doors
Electric 0 Plumbing Sprinkle/rs Generator Roof
Total S Ft of Construction: q. LT e S . Ft. of First Floor: _
Cost of Construction: $ / `i®, O a D, � Utilities:C2 Sewer []Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jack Morren
Name: Richard Murray
Address:204 E Main St.
Company: Shoreline RV & Mobile Home Repair, Inc.
City: Caledonia State: MI
Address: 1290 NE Business Park Place
City: Jensen Beach State: MI
Zip Code: 49316 Fax: n/a
Phone No. _ ( 16' �� " 2.7 3
Zip Code: 34957 Fax: 772.334.4335
E-Mail:
Phone No. 772.334.4334
Fill in fee simple Title Holder on next page ( if different
E-Mail: RFM9815@aol.com
from the Owner listed above)
State or County License: 16673/CRC57268
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name: T HAwm s7rnrn t3 Avc_(4
Address: 301- AUC of C)je*nnPid"-t
City: PALM MC-- WC14 C ,-a'W-Iwls State: r—
Zip: 3 3 (1 f3 Phone: S& (-a a Z- t, er 4
FEE SIMPLE TITLE HOLDER: x Nott pplicable
Name:
Address:
City:
Zip: 7 Phone:
MORTGAGE COMPANY: x N plicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
Zip: hone:
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 your Notice of Commencement.
Signature of -owner/ Agent/ Lessee
STATE OF FLORIDA
COUNTY OF_MeFlirf
The forgoing instrument was acknowledged before me
this 2nd day of May , 20 14 by
Signature of Contractor/License Holder
STATE OF FLORIDA
COU NTY OF.Mm- irr 5 k LJ c i
The forgoing instrument was acknowledged before me
this'2nd day of May , 2014 by
Richard F. Murray Richard F. Murray
(Name of person acknowledging) (Name of person acknowledging)
ignature of Notary Pula -State of Florida) NSetF\o(Signature of Notary
�o,�
Personally Known s OR
Type of Identification Prod
J
Commission No. l; E
Revised 07/15/2014
0 ea`i'ia�Personally Known "A
gvt . PSSQ ype of Identification P
My(�e��`�ou9r Commission Ni L�
Sri0APOW
` F
State of Florida )
OR Produced Identificatio
iced 'u 0
p G1Vt Ftoclda
DEf ate 2,A6
Netafq ?u, �0
\Jeoe n # EE 850 6 Assn_
BopdeCthtou9h�°.,_,.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIf W
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS