HomeMy WebLinkAboutBuildng Permit ApplicationALL APPLICABLE INTO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
5 J
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 �C
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 1206 NETTLES BLVD
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1206 AND PRO -RATA SHARE IN COMMON ELEMENTS (OR 3981-2078)
Property Tax ID #: 4502-501-1393-000-9
Site Plan Name:
Project Name: Walter
Setbacks Front
Back: Right Side: Left Side:
Lot No.
Block No.
1 DETAILED DESCRIPTION OF WORK: I
New 200 AMP meter main
CONSTRUCTION INFORMATION:
Additional work toa er orme under t is permit c ec a appy:
HVAC 11 Gas Tank L]Gas Piping Shutters ❑ Windows/Doors
QElectric ❑ Plumbing O Sprinklers Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: 610
Cost of Construction: $ 1800
5Ft. of First Floor: _
Utilities:'n Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Deborah Walter Charles Walter
Name: Donald B Green
Address: 1191 Nettles BLVD
Company. Don Green Electric
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.
Address: 1305 W 1st Street
City: Fort fierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-418-5739
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: dongreenelectdc@grnail.com
State or County License: EC13007447
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
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: X Not Applicable
game:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 thepermit 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
commencinia work or recording your Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner j Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF IJ
The fo oing instrument was acknowledged before me
this day of i, l 20 j_by
Personally Known
Type of Identificai
10 H,R,I TINE COPELAND
Commission No. + YP`04n My 910 SIGN#FF94B042
EXPIRES: JAN 05. 2020
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF tA
The forgoing instrument was acknowledged before me
this Q day of 4 tai C._ 20 L by
(Nampyof person acknowledging)
re of Itlotary'Public- State of -Florida )
PersonallyKnown OR Produced Identification
Type of Identification P duced
Commission No.
JOY CHRISTNE COPELAND
MY COMMISSION #FF948042
Bonded through 1st State Insurance
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