HomeMy WebLinkAboutappALL APPLICABLE INFO MUST BE COMPLET FOR APPLICATION TO BE ACCEPTED
Date: Permit Permit Number:
RECEIVED
Building Permit Application AUG 01 2019
Planning and Development Services
IiST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Dock/Seawall
:PROPOSED IMPROVEMENT LOCATION:
Address: 1255 NETTLES BLVD
I
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1255
4502-501-1442-000-8 1255
Property Tax ID #: Lot No.
Site Plan Name: Block No.
I
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'O,F WORK: .
REPAIR AN EXISTING DOCK AND INSTALL A BOAT LIFT l\
72> Pu CC s 12-91-RZ 1-r
CONSTRUCTION
INFORMATION:
Additional work to a er orme under this permit — check a apply:
�HVAC E] Gas Tank ❑Gas Piping Shutters a Windows/Doors
_
Electric ❑ Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ �� 3�0'� Utilities:�Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MICHAEL CARBAUGH
Name: - _ _ '� �
� TREASURE COAST BARGE, INC
Company: C
Address: 1255 NETTLES BLVD
Address: 1200 SE CUTOFF ROAD
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
City: STUART State: FL
Phone No. (937) 654-4446
Zip Code: 34994 Fax:
E-Mail: sandy96@aol.com
Phone No. 772-201-9777
Fill in fee simple Title Holder on next page (if different
E-Mail: JERNER(LDBELLSOUTH.NET
State or County License: 20077
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN _LAW INFORMATION:-. '
DESIGNER/ENGINEER: _ Not Applicable
Name: PAUL WELCH, INC
Address: 1984 BILTMORE DR #114
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 772-785-9888
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
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 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 concdrrency 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
:ommencine work or recording your Notice of commencement.
"�,Ih�=% / q-1� �
Signature of Owner/ Lessee/Co actor as Agent for Owner SYgnature of Contractor76teAnse14older
STATE OF � , STATE OF FLORIDA n
COUNTY OF FLORIDA. . `C_. _
COUNTY O
The f oing instru nt was acknowledg before me The fo str r�� as acknowledgq�before me
this day of 201� by this a(y,of cJ /A0 Q" by
iOA � � 1 C 6LL-Q—
Name of perso aking statem t Name person ' g statement
Personally Known OR Produced Identification Persona ow OR Produced Identification
Type of Identification Type o Identi icatio
Pr-duced Produ ed
t � `
(Signature of Notary Public- State f Flo N 411 It St@*'•OFlorida) LUCYIULIANO
SHELLI EST R ��,o';`; Notary Public - State of Florida
[�(� (� o °4% e� • € jsio� 9 GG 101693
Commission NdUv —1 1 �T �cState of Ff ii�,;g�ppR�ic z..
+_ ;' M Comm, Ex0res Aug 30. 2021
Commissi n # GG 194634 `•,�,.,.,, .
My Com i8sion Expires
Bcr�d$rcuchM1aticralMtaryAssr,
�i,EOr eIOA� res --
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ATE
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