HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR Al-PLICATION TO BE ACCEPTED
Date: �� %� tiL0&.L0 Permit Number -
BY S%p1'iPPrn�^+
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 1250 NETTLES BLVD
Y 17b- V
r4IC-11;
JUN 12 2018
Permitting Department
St. Lucie County, FL
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Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1250 AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID #: 4502-501-1437-000-0
Site Plan Name:
Project Name: KAPPLE DOCK
Setbacks Front Back:
DETAILED. DESCRIPTION OF WORK:
Right Side:
REPLACE AN EXISTING DOCK IN SAME LOCATION
Left Side:
Lot No. 1250
Block No.
CONSTROCTION INFORMATION:
Itlona wor to je ne orme under this permit -check
11HVAC L _1 Gas Tank -]Gas Piping
all
apply:
_Shutters
a Windows/Doors
11 Electric ❑ Plumbing
OSprinklers
ElGenerator
EIRoof Roof pitch
Total Sq. Ft of Construction:
S Ft. of°First Floor:
Building Height:
Cost of Construction: $
Utilities:
Sewer
Septic
OWNERJjft.
CONTRACTOR:,
Name XKAPPLE
Name:��--
Address: 1250 NETTLES BLVD
Company: TREASURE COAST BARGE INC
City: JENSEN BEACH State:FL
Address: 1200 SE CUTOFF ROAD
Zip Code: 34957 Fax:
City: STUART State: FL
Phone No. 4 4- - 3
Zip Code: 34994 Fax: 221-1611
E-Mail: hakapple@att.net
Phone No. 201-9777
Fill in fee simple Title Holder on next page (if different
E-Mail: JERNER@BELLSOUTH.NET
from the Owner listed above)
State or County License: 20077
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: PAUL WELCH _
Name:
Address: 1984 BILTMORE ST#114
Address:
City: P State: FL
Zip: 34984 Phone 785-9888
City: State:
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 your Notice of Commencement.
A k
Signature of wner/ Lessee/ o tractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF NkAa_-r, r-1
The forgoing instrument was acknowledged before me
this 1 I bi day of M" , 20 I $ by
4A-a i $y . i�P P l�
Name of person aking statement
Personally Known OR Produced Identification
Type of Identification
Produced
,�oqc, R) 74
(Si ture of Notary Pub ' - to of Florida )
Commission No.
of
Holder
STATE OF FLORIDA 'AA ll
COUNTY OF t IV
The r instru
th:'s day of
Name of f
Personally Know
Type of I en iflcati
JSe 1) HEATHER HOFFM Lon
'46m� Notary Public, State of lorida
Commission# GG 19 062
Afiu nnmm nvnirac Mnr 1 _ 2022
is acKnowiedg erore me
20 by
r
aking statement
OR Produced Identification _
re f otar10%hcVtate of Florida )
No. Cv JULO meal)
` o bllc-StateofFlorida
Commission = GG 101693
>' ? My Comm. Expires Aug 30.2021
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SUPERVISOR
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FRONT
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DATE
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DATE
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Rev. 8/2/17