HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/20/2017 Permit Number:.,
Building Permit Application
Planning and Development Services AUG 2 12017
Building and Code Regulation Division
2300 Virginia A venue,Fort Pierce FL 34982 St. Lucie County, FL
Phone,(772)462-1553 Fax.:(772) • Residential XXX
I PPLICATION FOR: To Select from dropbox, click arrow at the and of line
Address, 91 Nettles Blvd Jansen Beach Fl 34957
Legal Description: N07LES ISLAND INC,A CONDO-SECTION 11 PARCELM AND PRO-RATA914ARE IN COMMON ELEMENTS(OR&47-1327!970-827.1125-809;2831�15")
Property Tax 1D#: 4502-501-0277-000-3
Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:
Left Side.
Replace 3 Ton Mobile Home Package A/C with 10 KW Heat Strip
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!�Vdltiona—Fwork t o- 'be—nerto his pe- —c aii that apply:
1014VAC 13 Gas Tank ■Gas Pi in EiShutters Windows/Doors
OElectric F1 Plumbing OSprinklers O'Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq-Ft.of First Floor:
Cost of Construction:$ 4795.00 Utes:HSewerF]Septic Building Height:_
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Zip Code: $4957 Fax:
Phone No.772-229-3141
E-Mail.
Fill in fee simple Title Holder on next page(if different
from the Owner listed above) FlITIVUSIMAK",
If value of construction Is$2500 or more,a RECORDED Notice of Commencement is required.
NEED=
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 parmit 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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA , STATE OF FLORIDA� j
COUNTY OF (3V 11I COUNTY OF
The forgoing instrum` t was acknowledged before me The forg_cng instrument was acknowledged before me
this day of `o e, zo 1
, by •this 27tYd�ay of a,'Me, 20 _L7 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 OR Produced Identification _ Personally Known ' _OR Produced f ent ficatlon
I Type of Identificati'on?Produced �O'liilol � Type of identification produced f li A sl—
Commission No. Commission No. (Seal)
1fiiAwoft Amami
Kenter;>;
Revised 07/1:5/201 ►0MUM Eigtlr�s 04/[0
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS