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All APPLICABLE`c� INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
IDate: to Permit Number: 1 \rz�6�d 11
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
Building Permit Applicati n JUN 7U19
�ST. Lucie County, Permitting
Commercial Residential_
PERMIT TYPE: v t
PRO,POSED,INIPROVEM'ENT LOCATI' 1V1
Address: 4 S;��\— Lz0. tl �V2. �� ��► �CcQ_ �L-i °�� �
Property Tax ID #: \!:> (j\ " bt)b - CA q c)- c�- Ob'" -5=, Lot No.' c a
Site Plan Name: 'V Block No.
Project Name: CSZ
DETAILED DESCRIPTION OF WORK
CONSTRUCTION 1NFORM"ATION:
"k
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator Roof
� v2 Pitch
Total Sq. Ft of Construction: �1- OOn Sq. Ft. of First Floor: \�� `A
Cost of Construction: $ � i� Utilities: -Sewer _Septic Building Height: `S v
OWNER/LESSEE:'
`CONTRACTOR ,
Name aS'
Name:
Company:
iZ
Address:\\ L(O �o. Cl
City:' cT State:-S�J
Address:
C-c�yNkQeQ-
Zip Code: -JLI 61 Fax:
City: La
Stater
Phone No. 1 ! / ��g�
Zip Code: -.�`:2;dA Fax:
E-Mail:
Phone No
- -
Fill in -fee simple Title Holder on next page ( if different
E-Mail
C_\\
State or County Lice
se CC—\'J
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
r
•SUP"PLEMENTAL°CONSTRUCTION [ENIAW INFORMATION
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: 7X Not Applicable
Name:
Address:
City:
BONDING COMPANY: Not Applicable
Name:
Address:
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 SULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMME ENT ST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTE O OBT IN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTIC F COMM)E CEMENT."
gn ture of Owner/ L ssee/Contractor as Agent for Owner
SJgna ur Contractor/Lice se Holder
STATE OF FLORIQA
STATE OF FLORID /j
COUNTY OF S-\- L����
COUNTY OF Q_
before
The for oing instrument was acknowledged before me
The forgoing instrument was acknowledg d me
7SUr\Q_
this day of 7Sy t\2 20 \ by
this "day of 20, by
\� aC�\e,\ �OC �
u2Z:P\ G����
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification_
Type of identificationType
of Identific 'on
Produced A
Produced
(Signature pelic=1moss-10=1936445
o - o Ion a
.(Signature
`= MY
'= MY COMMIS N * F 9
.
Commission � v®n 6@6J)�19
Commission d;?,a,,•� EXPIRES Novombe(MaT19
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1407)3980.53 ) rySQrvcY.C.om
)407)398.0'59
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LOCATION MAP
LEGAL DESCRIPTION
LOT 1372, SECTION II, OUTDOOR RESORTS OF AMERICA AT
NETTLES ISLAND, A CONDOMINIUM, RECORDED IN PLAT BOOK
\ 16, PAGES 1, 1A THROUGH 1J, AND ACCORDING TO THE
\ DECLARATION OF CONDOMINIUM O.R. BOOK 186, PAGE 2720,
OF THE PUBLIC RECORDS OF ST. LUCIE COUNTY, FLORIDA.
\ MIN. QMACK RE61.
FROM 01.
\ N� GRAPHIC S$��j�� (�y�
i oro' -dL) ` J�
\ ( o7- 1374 \ D
\ INCLUDED \ ( IN FE T
J Mt IC=3
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/ D912112022
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NOTES:
1. Survey of description as furnished by Client.
2. Londs shown hereon were not abstracted for easements and/or
NOT VALID WITHOUT THE SIGNATURE AND THE rights -of way of record.
J. All bearings are referenced to the Easterly Line of subject property,
RIGINA1 RAISED SEAL OF A FLORIDA LICENSED 930'00' E t I- 4 th s bein relotive thereto
1. PROPERTY ADDRESS: 1372 NETTLES BOULEVARD O platted as south 1 as , w a o er g
SURVEYOR AND MAPPER. 4. Elevations shown hereon are relative to North American Vertical
Datum of 1988, and are based on benchmark N/A
2. CERTIFIED T0: 5. There are no above ground encroachments, unless otherwise shown..
STEPHEN J. BROWN, INC 6. The National Flood Insurance Program designation as Indicated on
—NORMAN &LEE ANNE TODD the FEM.A. Map No. 12085CO311K . dated 02/1s 2020 .
locates the parcel In Zone -X., base flood elevation N/A feet;
: Digitally signed by subject to any scoling and Interpolation factors associated with mapping of this
_ 'accuracy. This data Is an Interpretation by the surveyor and Is provided
-- Stephen J Brown as a courtesy. The flood zone(s) should be verified by a determination agency.
' 2023.07.28 Z Underground foundations & utilities not located unless shown.
8. The expected use of the survey and ma Is for Reslden tfal Purooses .
13:4f:00-04'00' P y P
STEPHEN J. BROWN, PROFESSIONAL SURVEYOR AND MAPPER s. All measurements are in accordance with the United States standard, in feet.
10. Additions or deletions to survey maps or reports by other than the signing
REGISTRATION NO. 4049, STATE OF FLORIDA party or parties Is prohibited without written consent of the signing party or parties.
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DRAM
S.J.B.
CHECKED
S.J.B.
DATE
09 22 2022
WALE
1" = 10'
JOB NO.
4056-111-01
MEET
ONE
OF ONE SHEETS