HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI 'il
1[�Date:
LIAPPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE CCEPTED
12 V / -n _ RECEIVED p rmit Num
JAN 0 9 2019
Bui "
. er ittin cation
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
l �VIDI
EX
2018
Permi ng alrtment
Lucie Coun FL
PERMIT APPLICATION FOR: Dock/Seawall III
Address: 1289 NETTLES BLVD
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1289 AND PRO-RATA SHARE IN COMMON
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front
4502-501-1476-000-5
LECLERC DOCK
Back: Right Side: Left Side:
Lot No. 1289
Block No.
DETAILED DESCRIPTION OF WORK: BY ill
REMOVE AN EXISTING DOCK AND CONSTRUCT AN B' X 20' DOCK. NO ELECTRIC
CONSTRUCTIONINFORMATION:
[3HVAC u Gas Tank
[]Electric 0Plumbing
Total Sq. Ft of Construction: �
Cost of Construction: $ ��' w^
Piping ��Shutters ❑ Windows/Doors
nklers E] Generator 13 Roof = Roof pitch
5 FFtt.I of First Floor:
Utilities: LlSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:_
Name ANDRE LECLERC
Name: V
Company TREASURE COAST BARGE, INC
Address: 1289 NETTLES BLVD
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No. 450-294-2707
Address: 1200.SE CUTOFF ROAD
City: STUART State: FL
Zip Code: 34994 Fax: ;
Phone No. 772-201-9777
E-Mail: ANMILEC@GMAIU.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: JERNER@BELLSOUTH.NET
State or County License: 20077
If value of construction is 525UU or more, a KtCUKUW IYOIIce oT l MMencemenl la Ieyw1 U
.,w
SUP'PL5IVIENTAL CONSTRUCT ON'LIEN'LAVV INFORMAl'ION:'
DESIGNER/ENGINEER: Not Applicable
Name: PAUL WELCH. INC
MORTGAGE COMPANY:
Name:
Not Applicable
Address: 1984 BILTMORE DR #114
Address:
City: PORT ST LUCIE State: FL
Zip: 34982 Phone 772-785-9888
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
i
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 Horne 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
commencingwork or recordingour Notice of Commencement.
Rev.8/2/17
I
I
Sig ature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Licens o der
STATE OF FLORJI�A.fI�
STATE OF FLORI
COUNTY OF ��'"`11((,,�dLCC�t
COUNTY OF
The forgoing instrument was acknowledged before me
this 2ln"""daygqof lUoyen.l,nx by
Th rgging inst[ m nt was ck owledg�before me
thi �66 �`dary�onfp2f0 by
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Name of person making statement
Nam