HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:A5 0 - 0
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Building Permit Application
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 Residential X
PERMIT APPLICATION FOR: Demolition
PROPOSED IMPROVEMENT LOCATION:
Address: 10851 S OCEAN DRIVE LOT 97
Legal Description: WINDMILL VILLAGE BY-THE-SEA CONDOMINIUM NO 1 UNIT 97
Property Tax ID#: 4511-810-0104-000-7 Lot No.97
Site Plan Name: WINDMILL VILLAGE Block No.
Project Name: WHITE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE OLD TRAILER AND CONCRETE PAD
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit—check a appy:
HVAC n Gas Tank ❑Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: /7 �, S . Ft.of First Floor:
Cost of Construction:$ 2000 Utilities:Lr 1 Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name William D White&SHARON WHITE Name: MACK MATOS
Address: 10851 S OCEAN DRIVE LOT 97 Company: MEL-RY CONSTRUCTION
City: JENSEN BEACH State:FIL Address: 10967 S OCEAN DRIVE
Zip Code: 34957 Fax: City: JENSEN BEACH State.FL
Phone No.772-229-0012 Zip Code: 34957 Fax: 772-229-9440
E-Mail: Phone No. 772-229-9439
Fill in fee simple Title Holder on next page(if different E-Mail: MACK@MEL-RY.COM
from the Owner listed above) State or County License. 23630
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: 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,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
commencing work or recording our Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLOf�#I[��A STATE OF FLOR1 A
COUNTY OF M_ e__1 COUNTY OFA,
Thefor oing instru ent w s acknowledged before me The forgoing instrument was acknowledged before me
this M day of 20/6by this-qday of 20 L5_ by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known VubOR Produced Identification Personally Known `' O Pr d ce i en 'ti ti, n
Type of Identification Produced Type of Idi iqaY Pqn,Produced
oo�P" �e��,, KATHLEEN C.SUMMERS
1 Commissio �I ° r�Ptate (4da
Com spnapo(�- KATHLEEN C.SUM °o; Y comm.Expires Dec 19,2 17
Notar p MFRS %'F,,,,�o? Commission # FF 069543
My comm.Expires Dec 19, n a
Revise &7,�� 2D17
�_ Pi�J/20f�mission #FF 0695'43
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
17 1
PianningBDevetopme tSenrices.- ASBESTOS NOTICE
;Building
OR-—9ulat3on Division,
2300 Virg[nia Avenue;
Fort.Pierce,FL 34982:
Phone(772)462 217Z'-F,t(772)x162-6443
Asbestos Notice to Contractor
October 12, 2015
MEL-RY CONSTRUCTION
MACK MATOS
10967 S OCEAN
JENS N BEACH,DFRL 34957 FILE CoPy
RE: Building Permit Number 1510-0041
It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department
of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal
law.
Signature
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Date
10/12/2015 9:24:54 AM