HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: Permit Number: � -lo OI j1 " 1
Building Perm it_ Application �U9WyadaO6 p7W
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
I gad
610190, HN
Residential 03X903v
PERMIT APPLICATION FOR: Dock BY
111119:r01Y�A1�®1ID/19aUYdal�/1iU®®lilfwl\lIIIU
Address: 1236 NETTLES BLVD, JENSEN BEACH, FL 34957
Legal Description: NETTLES ISLAND INC, A CONDO - SECTION II PARCEL 1236 AND PRORATA SHARE IN COMMON
ELEMENTS (OR 39-1001 )
Property Tax ID #: 4502-501-1423-000-9 Lot No.
Site Plan Name: GROSSMAN Block No.
Project Name: GROSSMAN
Setbacks Front Back: Right Side: Left Side:
REMOVE AND REPLACE A 200 SQ. FT. +/- DOCK IN SAME LOCATION, FOOTPRINT AND
CONFIGURATION AS EXISTING.
UHVAC L_I Gas Tank UGm
Electric 0 Plumbing ®Spi
Total Sq. Ft of Construction:
Cost of Construction: $ 10,000.00
nitnitchecall apply:
Piping In _Shutters
nklers ❑ Generator
_ S� cFt. of First Floor:
Utilities: L_I Sewer ❑ Septic
❑Windows/Doors
0 Roof = Roof pitch
Building Height:
OWNER/LESSEE:
'CONTRACTOR: -
Name GROSSMAN
Name: ROBERT WILLIAMS
Address: 1236 NETTLES BLVD
Company: WILCO CONSTRUCTION INC
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: NIA
Phone No.614-361-3101
Address: 10751 ORANGE AVE
City: FORT PIERCE State: FL
Zip Code: 34945 Fax: 772-460-6929
Phone No. 772-460-6928
E-Mail: NIA
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: WILCOINC@BELLSOUTH.NET
State or County License: SCC131151026 29115
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN'LAW INFORMATION:
Name: DANIEL PAUL RETHERFORD
Address: 1402 HARTMAN RD
City: FORTMERCE State: FIL
Zip: 34947 Phone: 772-224-9e26
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name: _
Address:
City:
Zip:
Phone:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:
Zip: Phone:
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, 1 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
rommencine work or recordine vour Notice of Commencement.
as Agent
STATE OF FLORIDAf
COUNTY OF L
The forgoing instru nt was acknowledged before me
this J_� day of Rb 20 by
(Name of person acknowledging)
(Signature of Notary -Public- Si"ate of Florida )
Personally Known V OR Produced Identification
Type of Identification Produced
Commission No. 2i `�" DAN.MHTb�Fru
tj""—u�ar.1?SSI}}:''Ft=fi`,G1623.E
6i3?r. Ai,,_:, �evoin[s ❑ecemt2r
Revised 07/
s
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrug3pot was acknowledged' Gbefore me
this A day of 1'c� 20 A by
Rstrq: MWa%
(Name of person acknowledging)
(Signature of Notary, Public- State of Florida
`' )
Personally Known OR Produced Identification
Type of Identification Produced
'p'v d"••, DAWN RND
Commission No. � `" COA9N9SMt.. GG 16234E
�.o`= EXPIRLb: December 17, 2021
WCOMMISSION#GG 1623J1
EXPIRES: December17,2021
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
PLANS
REVIEW
DATE
COMPLETE
INITIALS