HomeMy WebLinkAboutBuilding Permit Application3�13f��z
ALL APPLICABL INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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: Mechanical
PROPOSED IM'RROVEMENfLOCATIO'N:°
Address: 274 NETTLES BLVD
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 274
Property Tax ID #: 4502-501-0460-000-3
Site Plan Name:
Prniprt Nnmp-
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OFVORK
� S _o -=OAC IS .v N O-Z—T
Lot No.
Block No.
CONSTRUCTION ,,INFORMATION:
itiona wor to e e orme under this permit— check a appy:
HVAC El Gas Tank F]Gas Piping _ Shutters a Windows/Doors
❑✓ Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 180 Utilities: Sewer Septic Building Height:
OWNER/LESSEE"
CONTRACTOR:
Name ROCHA RAYMOND, CIDALIA
Name: TODD PERLMUTER
Address: 21 Perryville RD
Company: SERVICE AMERICA
City.. Rehoboth State: MA
Zip Code: 02769 Fax:
Phone No.
Address: 2755 NW 63RD
City: FT LAUDERDALE State: FL
Zip Code: 33309 Fax: 954-977-3591
Phone No. 954-979-1100
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: epermitsgroup@serviceamerica.com
State or County License: ECC0002822
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires.
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION;:
Signaturerof ContractW-License Holder
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
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, 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 wi en�ern attorney before
commencing work-at-recor--dhag-ftuq'Notice of Commenceme_I�t�--
Signature of 6wner/L8see/Co6tradt6r as Agent for Owner
Signaturerof ContractW-License Holder
I
STATE OF FLORI'�oc
STATE OF FLORIDP
A
COUNTY OF�Ja►
COUNTY OF T:>✓o��rC1
The forgoing instr m t was acknowledged before me
The forgoing instr m t was acknowledged before me
this ZS day of at— 20 ��by
this �` day of 11 L, 20 1-7 by
REVIEW
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l►�sar�
1 IG �iC.V 10
(Na of perso now
(N a of perso acknowled
Sheneka Hardy
Notary Public- State ofFlo rld
t�'RY pVb
1 Sheneka Hardy
Commission#GG 33870
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. Notary Public - State ofFlorida
v
(Si ture f Nota Pub] - _ �Q loridal�xpnes
(Si t e of N ary f lision#GG33870
O. r, o� Expires 9/27/2020
Pers n OR Produced Identification
Pers o ally Known 0 ro uc 1'Ttferrtifiea
Type of Identification Produced
Type of I en i ication Produced
Commission No. (Seal)
Commission No. (Seal)
Revised 07/15/2014
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