HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
St Lucie CountY
Building Permit Application FEB 0 8 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxx,
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 1 -7, 13 /V (! 17 I.p s (J I ✓' l/
Lega I Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1217 AND PRO-RATA SHARE IN COMMON ELEMENTS (OR 2822-1905)
Property Tax ID #: 4502-501-1404-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Remove and replace dock as necessary due to damage from Hurricane Irma.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit- check all apply:
11HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 01 Generator E]Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 10000
Sq.
of First Floor: _
Utilities: 0 Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name�
Name:
r
Address
Company: '
"�
�!'6), 00
City: a State:Rl
Address: _j (2 (�
2 mil^(
Zip Code: 02879 Fax:
City: 9 k/ 'A
Stater
Phone No.401-935-7374
Zip Code: 3 q ":1 6j Lf
Fax:
E-Mail:dgolson28@outiook.com
Phone No. -7 2 -
% - Z
Fill in fee simple Title Holder on next page (if different
E-Mail: 160,1 d ro
S f�'' O
State or County License:
-'7A� 0 2,
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
Not Applicable
Name: --'Cv ( v
Address: k 5(,/ M '
City: AYDLS v I%i t State:
Zip: t,Phone 7 7 2, — 7r,(--=
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 thf
bsite
before the first inspection. If you intend to obtain financing, consl{It with lender or an attorney be e
commencing work or recording vour Notice of Commencement. / _
GiggatreaofiOwne r Lessee/Contractor as Agent for Owner Sign ure of Contractor/License Holder
STATE OF FLORID STATE OF FLORI
COUNTY OF /��� COUNTY OF '4'
The for oing instru ent was acknowledged before me
this day o,l ei-t� 20-4rby
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
J�
The forgoing instrument was acknowledged before me
this tn—day of C-r u 26 by
66 s LAW C=el)
Name of perspfimaking statement
Personally Known OR Produced Identification
Type of Identification
Produced
A
(Signature bf No4ue
� IKONRATH
ign urls of ry Pub' TH
;;, YLE KONRACommission
No.O�ON # GG060206
,
mmission NoMY
C IsnSION # GG06020
PIRES Jarnivy 06, 2021
•
�; EXP F0
"January 05. 2021
1111
REVIEWS
FRONT
ZONING.
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
RECEIVED l�;ro I �✓�—�8
DATE
COMPLETED
Rev. 8/2/17