HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONQFFICE-USE ONLY.
DATE FILED: s 4`
PLAN REVIEW FEE:
CONCURRENCY FEE: RECEIPT NO.:
1.
2.
3.
4.
ALL INFO MUST BE COMPLETE &
PLANNING & DEVELO
BUILDING & COI
2300
Ft. Pier
PERMIT NUMBER: ' �bd 5 d3
CERT. CAP. NO.:
. ED IN TO BE ACCEPTED
VIENT SERVICES DEPARTMENT
REGULATIONS DIVISION
ginia Avenue
FL 34982-5652
62-1553
APPLICATION for BU DING PERMIT
CERTIFICATE of CAPACITY/NIN I G COMPLIANCE
PROJECT INFO TION
LOCATION/SITE ADDRESS: 501 nettles blvd Jensen Beach FI 34957
PROJECT NAME- SITE PL7 NAME:
PROPERTY TAX ID #: 4502-501-0687-000-0
I
LEGAL DESCRIPTION (attach extra sheets if necessary): nettles island inc a condo-sec11 part
andpro -rata share in common elements
501
5. PLAT BOOK 6. PAGE NO. 7I BLOCK NO. 8. LOT NO.
06 acres I
9. PARCEL SIZE (ACRES/SQ FT.): 0.LOT D NSIONS:
10. COMPLETE DESCRIPTION OF CONSTRUCTION PROJEC OR WORK ACTIVITY: re -build exterior wall of
porch with pt wood, re frame windows to sizes shown relocate washer/dryer, install new shov
stall, install landing /steps at rear of property
11. SETBACKS (ACTUAL) FRONT: BACK: I RIGHT SIDE: LEFT SIDE:
12. TYPE OF CONSTRUCTION (Check all appropriate boxes)
[ ] NEW CONSTRUCTION [ ] EXPANSION/AD ITION [)q INTERIOR RENOVATION
[ ] RESIDENTIAL [ ] COMMERCIAL [ ] INDUSTRIAL
[ ] OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: I
14. SQ. FT OF CONSTRUCTION: 15. SF. FT 1st FLOOR 1062 sq ft
16. VALUE OF CONSTRUCTION: $ 2475.00
The value of construction is used to determine the amount of permit fees to be assessed. St. Lucie County reserves the right to question and/or modify the indicated
value of construction if it is demonstrated that the submitted figures are not consistent with similar types of construction activities. If the value is $2500 or more, a
RECORDED Notice of Commencement must be submitted with this application.
SLCCDV Form No.: 001-02
i � av
1�
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UPDATED 6/25109
i1
OWNER INFORMATION
NAME: Jack Root
ADDRESS: 501 nettles blvd
34957
CITY: Jensen Beach STATE: fl ZIP:
PHONE (DAYTIME): (___) Email:
IF THE FEE SIMPLE TITLEHOLDER (PROPERTY OWNER) IS DIFFERENT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLDER -
ADDRESS:
CITY: STATE: ZIP:
PHONE (DAYTDvIE):
CONTRACTOR INFORMATION
ST. of FL REG.CERT #: cgc1516251 ST. LUCIE COUNTY CERT #:
Sherlock Homes of the treasure coast IIC
BUSINESS NAME:
QUALIFIERS NAME: John Mc Quaid
10380 sw village center dr s-302
ADDRESS:
CITY: PORT ST LUCIE STATE: FL
34987
ZIP:
PHONE (DAYTIME): C� 529 0136 FAX NO. 866 913 2290
Email: JOHNNYMCQUAID@
YAHOO.COM
ARCHIT/ENGINEER: DAN STUART DAVIS AIA
ADDRESS: 7410 S, US-1 #310
CITY: PORT ST LUCIE STATE: FL
ZIP: 34952
PHONE (DAYTIME): ( 7 2 343 0340 FAX 772 343 0436
N/A
BONDING COMPANY:
ADDRESS:
CITY: STATE:
ZIP:
MORTGAGE LENDER:
ADDRESS:
CITY:
STATE: ZIP:
IMPORTANT NOTICE: When a permit is issued and it is not picked up within 60, dais after pOtiflCation
it will be voided and returned to you by mail.
I
T, - - -1
CERTIFICATION:
This application is hereby made to obtain a permit to do the work and installatic
if applicable, for the permitted work. I certify that no work or installation has a
work will be performed to meet the standards of all laws regulating construction
may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POO]
AND AIR CONDITIONERS, FENCES, ETC., not otherwise included with th
indicated, and to obtain a certificate of capacity,
iced prior to the issuance of a permit and that all
s jurisdiction. I understand that separate permits
CTRNACES, BOILERS, HEATERS, TANKS,
(ding permit application.
St. Lucie County makes no representation that its granting of a permit will autliorize the permit holdef to build-tlie, subject structure
which is in conflict with any applicable Homeowner Association rules, bylawg or any covenants that may -restrict or prohibit such
structure. Please consult with your Homeowner's Association and review your deed for any restrictions which may apply.
The following building permit applications are exempt from undergoing a (full concurrency review: room additions, accessory
structures (all types), swimming pools, fences, walls, signs, screen rooms, µtihty substations & accessory uses to another non-
residential use.
NOTICE TO OWNER: YOUR FAILURE TO RECORD A NOTIq OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTSI TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE REC64D AND POSTED ON THE JOBSITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE,ISJECT
NTEREST THAT IS SUBJECT TO
ATTACHMENT: AS A CONDITIONSUANCE OF THIS PERMIT, YOU PROMISE IN
GOOD FAITH TO DELIVER A COPHE CONSTRUCTION LIEN LAW NOTICE TO
THE PERSON WHOSE PROPERTY ITO ATTACHMENT.
qf VV
OWNER OR CO CTOR SIGNATURE COI.TRACTOR SIOATURE
STATE OF FLORIDA STATE OF FLORIDA / _
COUNTY OF Z5-t zu � � COUNTY OF S f Lu Cal
The foregoing instrument was acknowledged before The oregoing instrument was acknowledged before
me this 23 day of 05 20 / 3 , me his 13--day of ���/ , 20 / 3,
by by /U
who is personally known or has produced wh is personally known or has produced
i entification. Sa Sri O —&a identification.
Signature of of v KIVEI.Y OPIZO zature of N?FWL
_
A Notary Publfc� State of Florida KIVFLY OPI=O
Commission No. $ Comn" E 25027 mission NNotary P4kdltpte of Floridacomm. expires Oct. 5, 2014 Commiswl EE25027
comm. expres Oct 5, 2014
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN
THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION.
OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS.
For specific instructions see appropriate permit