HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J-_
` - Building Permit Application
Planning and Development Services APS; ® 7 2016
Building and Code Regulation Division Public V(;z r k s
2300 Virginia Avenue,Fort Pierce FL 34982 t. Lur.le County, FL
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR:. , ; ilia
PROPOSED IMPROVEMENT LOCATION:
Address: 1308 NETTLES BLVD,JENSEN BEACG, FL 34957
Legal Description: NETTLES ISLAND INC,A CONDO-SECTION II PARCEL 1308 AND PRO-RATA SHARE IN COMMON ELEMENTS(OR 3827-1020)
Property Tax ID#: 4502-501-1495-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE CONCRETE PAD
CONSTRUCTION INFORMATION:
Additional work to (e D orme under this permit—check a app y:
HVAC H Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers FI Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor: 941
Cost of Construction:$ 1,500 Utilities: Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Andrew&LILY Litynskyj Name: MACK MATOS
Address:6109 Windemere LN Company: MEL-RY CONSTRUCTION
City: Shelby Township, MI 48316 State:Ml Address: 10967 S OCEAN DRIVE
Zip Code: 48316 Fax: City: JENSEN BEACH State:FL
Phone No.772-229-0012 Zip Code: 34957 Fax: 229-9440
E-Mail: Phone No. 229-9439
J. 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: _Not Applicable
ame: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: x 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 recordingour Notice of Commencement.
Sign:ur Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF 1.�c'�E COUNTY OF - ��,
The for ing instrument w�,s acknowledged before me The f rgoing instrum nt was acknowledge efore me
this/3 day of )618 /7 20/6by this day of 20 by
(Name of erso ck owl edging) (Na o erson acknowle ing)
(Signature of Notary Public-State of Florida) (Signature of Notary blit-State of Florida)
P sonally Known ersonally Known R Produced Identification
entificati Ep904jcecV4ota Public State of Florida Type of Ide oduced
Christine Matos
Commission No.
< MycommissE 224190 Commi s 0( ; 4, , (Seal)
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ate na/ 2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIO MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW R REVIEW
DATE
COMPLETE
INITIALS