HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE CONo_-,S1rED�FOR APPLICATION TO BE ACCEPTED"
Date: �if -� • dL Permit Number: 2) 3
f5L RECEIVED
Building Permit Application
Lucie
Planning and Development Services St Perrmittingnry
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: To Select from dropbox, click arrow at the end of line
PROPyOSED IIVIPROV.EIVIENT � I:� R
Address: 1096 NETTLES BLVD., JENSEN BEACH, FL 34957
Legal Description: NETTLES ISLAND INC., A CONDO=SECTION II PARCEL 1096 AND PRO-RATA SHARE IN COMMON
ELEMENTS.
Property Tax ID #: 4502-501-1283-000-5
Site Plan Name:
Project Name: GAMAYO RESIDENCE
Setbacks Front Back:
INSTALL ELEVATOR LIFT.
AC
Right Side:
Left Side:
Additional work to be nertormed under this permit— check all apply:
11HVACD Gas Tank , Gas Piping _ Shutters
1-1 Electric ❑ Plumbing ❑ Sprinklers FIGenerator
Total Sq: Ft of Construction:
Cost of Construction: $
S Ft. of First Floor: _
Utilities:n Sewer O Septic
Lot No.
Block No.
❑ Windows/Doors
Roof Roof pitch
Building Height:
'OWNER/LESSE;E���,�CONTRACTOR
. .
.� r :.
�.�
Name ROBERT GAMAYO
Name: CHRISTOPHER LOUDON
Company: MARLAND CONSTRUCTION
Address: 7840 NW 170TH TERR
City: HIALEAH State: FL
Address: PO BOX 1138
Zip Code: 33015 Fax:
City: PORT SALERNO State: FL
Phone No.
Zip Code: 34992 Fax:
E-Mail:
Phone No. 772-223-0105
Fill in fee simple Title Holder on next page ( if different
E-Mail: MARLAND@BELLSOUTH.NET
from the Owner listed above)
State or County License: CBC1253377
It value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name: _
Address:
City:
Zip:
Phone:
Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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 rec n the JobsIte
before the first inspection. If you intend to obtain financing, cons lender or an attorney _fore--` "
commencing work or -wording vour Notice of Commenceme
Signature of Owner/Lessee/Contractor as Agenffor Owner I Sig
r/License Holder
STATE OF FLORIDA STATE OFF LORIDA �*
COUNTY OF `�-'li� ��- COUNTY OF 1�
The forgoing instrument was acknowledged before me The foing ins ment was acknowledged before me
this ��ay of ()JeM - 20 021 by this day of 20 by
1 1 '►YY1
(Name of person acknowledging) (Name of
a,L,c llqa�ALi —
(Signature of Notary Public- State of Flor da) 4in
Personally Known OR ro luced I e ti i a 'o
Type of Identification Pr uce�
Tare Maic z
Commission No. MMyC"k!o"U7
GG2099e9
Expiras 0.2022
Revised 07/15/2014
ry PublicJStatebf Florida )
Personally Know OR Produced Identification
Type of Identification
��ary-Pule
Joy Christine Copeland
Commission No. ' Mycommi" P31752
Expxes 01l0 202
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