HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ���I SCANNELermit Number:
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Buildings Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
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2,v
KECEIVED
MAR 0 6 2018
ST. Lucie County, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 ,Commercial Residential
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 6 NETTLES BLVD, JENSEN BEACH, FL
Legal Description:
NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 6A
Property Tax ID #: 4502-501-0192-000-3
Site Plan Name: MCINTOSH
Project Name: MCINTOSH
KI
PRO-RATA SHARE IN COMMON ELEMENTS (OR 640-97: 3285-674)
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: "
REPLACE EXISTING DOCK IN SAME LOCATION & DIMENSIONS
CONSTRUCTION INFORMATION:..
Lot No.
Block No.
Additional work to jbe performed under
0HVAC
this permit —check
❑Gas Piping
a
apply:
Shutters
a Windows/Doors
LJ
Gas Tank
_
Electric El Plumbing
�Sprihklers
Generator
E] Roof Roof pitch
Total Sq. Ft of Construction:
8,000.00
Sq. Ft. of First Floor:
Height:
Cost of Construction: $
Utilities:
Sewer
_
Septic
Building
OWNER%LESSEE:
CONTRACTOR:-
Name EDWARD MCINTOSH
Name: ROBERT WILLIAMS
Address: 6 NETTLES BLVD
Company: WILCO CONSTRUCTION INC
City: JENSEN BEACH State: FL
Address: 10751 ORANGE AVE
Zip Code: 34957 Fax:
City: FORT PIERCE State: FL
Phone No. 231-882-4990
Zip Code: 34945 Fax: 772-460-6929
E-Mail: N/ A
Phone No. 772-460-6928
Fill in fee simple Title Holder on next page (if different
E-Mail: WILCOINC@BELLSOUTH.NET
from the Owner listed above)
State or County License: SCC131151026 29115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW I
DESIGNER/ENGINEER: — Not Applicable
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORT PIERCE
Zip: 34947
Phone: 772-224-9826
State:) FL
FEE SIMPLE TITLE HOLDER: x Not Applica
Name:
Address:
City:
Zip: Phone:
3RIVIATION:
MORTGAGE COMPANY: x Not Applicable
Name:
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 grantingia 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 Buildinig 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. '
5
/Contractor as Agent for Owner Signature oT Contractor/License Holder
i
STATE OF FLORIDA COUNTYOF �J .
The f r oing instru nt was acknowledge efore me III
this day of 20 by
R6p6r1:;7
(Name of person acknowledging)
(Signature of NotaryPublic- State of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced_
G
Commission No. :ova;= DAWNOMMISF 162348
9*7 ,;: EXPIRES: December 17, 2021
Revised 07/1
STATE OF FLORIDA Si— U - J
COUNTY OF
The forgoing Instrument was ackn ledge before me
this day of CADI&L 11 20 Imo— by
�O'� ml I Q
(Name of person acknowledging)
(Signature of Notary, PubTic- State of Florida )
Personally Knowny OR Produced Identification
Type of Identification Produced
Commission
WCOMMISSION # GG 162U8
Bonded Thru Notary Pd* Undeiv IWS
REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
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DATE
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INITIALS
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