HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLICAPLQ FO US OMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � I / Permit Number: S4Nk�
i RECEIVE
Building Permit Application SEP - 4 2015
Planning and Development Services
Building and Code Regulation Division Public Works
2300 Virginia Avenue, Fort Pierce FL 34982 I St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR:
PROPOSED" IMPROVEMENT_LOCATION
Address: 1376 Nettles Blvd., Jensen'Beach, FL 34957
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Legal Description: Parcel 1376, Section II, Nettles Island Inc,
Property Tax ID #: 4502-501-1563-000-2 Lot No. 1376
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Site Plan Name: I Block No.
Project Name:
Setbacks Front Back: Right.Side: Left Side:
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"DETAILEI)bESCRIPTION" OF WORK: 4 "
Replace entry door with impact door/replace all windows with impact/ install new hardi siding
and trim, paint exterior.
CONSTRUCTION .INFORMATION:
Additional work to be nertormed under t is permit 'I check a I I tbat apply:
HVAC Gas Tank" Gas Piping Shutters Q Windows/Doors
11 Electric Plumbing O Sprinklers Generator Roof
Total Sq. Ft of Construction: ` S . Ft. of First Floor:
Cost of Construction: $ � Utilities:0 Sewer E Septic Building Height:
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OWN"ER/LESSEE:
CONTRACTOR:
Name Thomas and Nancy Bellavance
Name: James Newman
Address:1377 Nettles Blvd.
Company: JWN Construction
City: Jensen Beach State: FL
Address: 1701 SE Carvalho Street
Zip Code: 34957 Fax:
City: Port St. Lucie State: FL
Phone No.
Zip Code: 34983 Fax: 772-871-9500
E-Mail:
Phone No. 772-871-9500
Fill in fee simple Title Holder on next page (if different
E-Mail: jwnconstruction@comcast.net
from the Owner listed above)
State or County License: CRC1328282
If value of construction is $2500 or more, a RECORDED Notice of,Commencement is required.
�s.
VP Pt MENCONSTRUCTIO,N LIEN LAW INFORMi4TION
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone:
!
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
T Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
I
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counter 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 Buil8ing Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full cohcurrency 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, consWt with lender or an attorney before
commencing work or recording your Notice of Commencement./J
P (3AQp aw.�s�
%nature of Owner/ Agent/ Lessee
STATE OF FLORIDA
COUNTY OF L occ ,7
The fgrgoing instrument wa acknowledged before me
this J day of C 20 My
15 '
(Name of�pderson acknowledging)
ature of Notary Pub ' State of Florida )
Personally Known ---
Type of Identification
Commission No.
Revised 07/15/2014
OR Produced Identification
SignaAre of Contractor/License Holder
STATE OFF c_-_5� f '� �
COUNTY OF �—V
The Wing instrum cknowledged before me
this day of 20y
15
:(Name acknowledg
%,,
(Signature of Notary Public- State of Florida )
Personally Known'�OR Produced Identification
Type of Identification P�&Q� -- - - - -
SHARON K. NEINMAN
MYCOMI SON) EE8800oe Commission No.
EXPIRES: Apol 20 2017
Bonded Thru Notary Public Underwriters
SHARON K NEWMAN
MY COMI flN EE 880008
EXPIR S: p l 20, 2017
Bonded Thru Notary Public Underwriters
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