HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,e pLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED SCANNE� Permit Number: 06Liq
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Building Permit Application MAR 2 2 2018
Planning and Development Services
Building and Code Regulation Division Permitting D e pa rtm e n
23o0 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Re ide, till t�/, FL
PERMIT APPLICATION FOR: DOC10l eawall
PROPOSED IMPROVEMENT LOCATION:
Address
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION I PARCEL 60
4502-501-0063-000-0 Lot No.60
Property Tax ID #: Block No.
Site Plan Name: NETTLES ISLAND
Project Name:
__
Back: Right Side: Left Side:
Setbacks Front
DETAILED DESCRIPTION OF,WORK:
CONSTRUCT A NEW DOCK AND BOAT LIFT
CONSTRUCTION INFORMATION:
itiona wor to e e orme un er t is permit — c
❑HVAC _ Gas Tank ❑Gas Piping
9 Electric El Plumbing Sprinklers
apply:
_ Shutters ❑ Windows/Doors
Generator 0 Roof = Roof pitch
Total Sq. Ft of Constructi S Ft. of First Floor: Construction: Utilities Cn Sewer 0Septic
Cost of Cons $
OWNER/LESSEE:
rum, DENNIS DAVIS
Address:2060 NETTLES BLVD
City: J►�� �iiri- State
Zip Zip Code: 34957 Fax:
Phone No.561-373-7533
E-Maii:ALLDAVISWPB@BELLSOUTH.NET
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:.
Building Height:
Name:
Company: TREASURE COAST BARGE, INC
Address: 1200 SE CUTOFF ROAD
City: STUART State: FL
Zip Code:
34994 Fax: (772)221-1611
Phone No. i7721201-9777
E-Mail: JERNER@BELLSOUTH.NET
State or County License: 20077
If value of construction is sz500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not App
Name: PAUL WELCH
Add ress:1984 SE BILTMORE ST #114
City: PORT ST LUCIE
Zip: 34982 Phonen2a85-9888
State: FL
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name;
Address -
Not Applicable
Cif, -- 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 OwnerslAssoclation 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 firs pection. If you intend to obtain financing, consult with lender or an attorney before
commencipif work or recordinwwur Notice! of Commencement. c n
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLnaSTATE OF FL
COUNTY OFORIPP,( ' &- A-c 0 1COUNTYCIFORIDA
Oak
The for ng instruymr,e� t was acknowledged before me
this ay of Irut� 2o15' by
Name of person aking statement
Personally Known V OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission $SIpNy 1 8
;Y
11-
+� EXPIRES: December 25, 2018
9S t�,Qjr BNB Thm Notary Pubk Undemitere
The frg" nstru acknowledg d ev re me
this dayof Q� 20 b
Fr �l nh,
Name of person king statement
Personally Known OR Produced Identification
Type of Identifica
Prod ed
(Signature of N !aP McState of FloridaCommission No.IUNO
Notary Pug = 5t8te of Florida
Commission GG 101693
My Comm. Expires Aug 30, 2021
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Rev. 8/2/17