HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
COUNTY OF s-I� i`
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: V Not Applicable
Name:
'BONDING COMPANY:
Name:
Not Applicable
Address:
Address:
City:
City:
Personally Known t/ OR Produced Identification
Zip: Phone:
Zip: Phone:
Type of Identification
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 fender or an attorney before
commenciniz work or recording; vour Notice of Commencement.
Rev. 8/2/17
Signature of Owner) Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA, ,STATE
L6� C
OF FLORIDA r
COUNTY OF J" �—- i
COUNTY OF s-I� i`
-
The forgoing instr en w s acknowledged before me
The tgrgoing instrument,w s acknowledged before me
this day of 20 11 by
this day of 2044 by
CA—
Name of persa making statement
Name of perso}making statement
Personally Known t/ OR Produced Identification
Personally Known ,/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Flor-
(Signature of Notary Public- State of Florida j
Com IT, o,. 17P -117 -CE Fi1TCi1?f_eaI
�' B( ., tornr���ssia Fohlafa
Commission No. (Seal)
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REVI ) 398
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SUPERVISOR
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MANGROVE
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REVIEW
REVIEW
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REVIEW
DATE
(4(77] 388-Ot53 FloridallotaryServicE ccm
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. 10/30/2017 Permit Number:
iJ is
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 IMPROVEMENT LOCATION:
Address: 410 Nettles Blvd
Legal Description:
Parcel ID # 4502-501-0596-000-5
Property Tax ID ##:
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Change out 2 ton 15.5 seer Rheem heat pump split system 5 kw heater like for like
Lot No._
Block No.
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name Nettles LLC
Name: Vance R Corbin
Additional work toe e orme under this permit —check
HVAC Ei Gas Tank E] Gas Piping
a
appy:
_ Shutters
E.J, Windows/Doors
Electric E] Plumbing
Sprinklers
GeneratorL.�
Roof Roof pitch
Total Sq. Ft of Construction:
SFt. of First Floor:
Cost of Construction: $ 4500.00
Utilities:T]
Sewer
0
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Nettles LLC
Name: Vance R Corbin
Address: 410 Nettles Blvd
City,: Jensen Beach State- Fl
Zip Code: 34957 Fax:
Phone No. 616-437-3394
Company: Dodd Enterprises Inc
Address: 1296 SE Industrial Blvd
City: Port 5t Lucie State: FI
Zip Code: 34952 Fax: 335-3310
Phone No. 398-2344
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: doddenterprises@dodd.com
State or County License: CMC1249958
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.