HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: D a* 1 Permit Number:
RECEIVED
BY��r FEB 2 6 2018
Builc�rA#*9r Mt/Application
Planning and Development Services ST. Lucie County, Permitting
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.I•MP'ROVEMENTLOCATION
Address: 1044 Nettles Blvd
Legal Description: 1044 Nettles Blvd, Jensen Beach, FL 34957; lot# 1044
Property Tax ID #: 4502-501-1231-000-6 Lot No. 1044
Site Plan Name: Nettles Island Block.No.
Project Name:
Setbacks Front GO Back: Right Side: 6 J Left Side:
DETAILEQ,_DESCRIPTI.ON OF WORK
Jn-e ku %v,!� O\d -vc, �k-e—Z VaAN c�'e r� YM IAD &6C by M-0
W t t , \ k12- bc�kAl
CONSTRUCTION INFORMATION:
t vvo to e e orme un er this arm it. c ec a a
El
Ii i na r
HVAC 11 Gas Tank
LQELectric Plumbing
®Gas
p
Piping
pp y.
_ Shutters
Generator
Z—Windows/Doors
oof Roof pitch
E]Sprinklers
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ �• Utilities:E Sewer E Septic Building Height:
OWNER/LESSEE:
CONTRACTOR.
Name V.G.YN&a 1
Name: k kQCXC, \KkQj bD--*i
Addres Q jConstruction,
Inc.
City: S
Address:I�i�'tl.e1 5.l'�Ge.cw 6
.l-
Zip Code ��' 11,44
City: State•FL
Phone No, `i"1 _-'22-9 -1A A
Zip Code: 34957 Fax: N/A
E-Mail: I -A ^ A
Phone No. 772-229-9439
FLIT in fee simple Title Holder on next page (if different'
E-Mail: Mack@mel-ry.com & Teresa@mel-ry.com
from the Owner listed above)
State or County License: 059412
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION11EN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: 5C0+A_ 5clncC c z
Name:
Address: 5Gll1
Address:
City: �C.-_ State: �L
City:
State:
Zip: Phone '1'l Z-`I-1L1-al�8lo
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 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.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contract r/L cense Holder
STATE OF FLORIDA C `
COUNTY OF ' Li-tCL IF_COUNTY
STATE OF FLORIDA
OF Sk -b_kL` e-
.mot
The forgoing instrWent was acknowledged before me
The forgoing instr ment was acknowledged before me
this a day of _-Vw.4rA 20 l 8 by
this -I—. day of , . 0_ 20 l3 by
A AG G IC KC- S
WAC, CAL WCL
Name of person making statement
Name of pers n making statement
Personally Known �_ OR Produced Identification
Personally Known OR Produced Identification
Type o entification
Type of Identification
Pr uced
Pr uc
C T
�•
% 'tom'
(S•g ature o Notary Publir� ate oi�6r L.ICAMERIK
S'g ature ofY'rot ry Pu IIc- Stat :,F i
}MY COMMISSION # F
': MY..COMMISSION # FF227168
Commission No.� ZZ`1 • EXP&§Iktay 05. 2019
r,
I _
Commission No. Z`l>lLAg � "�`'' 1ISeal f xPIRES May 05.
•i-i:•5J rlmidallola'yseivice cun•
•IG7,Jt9-C'SJ rlwidallol"Sewice
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
-24
RECEIVED
(al (�'
1_/
DATE
COMPLETED
Rev. 8/2/17