HomeMy WebLinkAboutBuilding Permit Application 09/10/2018 MON 12: 32 . FAX U901/002
ALL APPLICABLE INFO Mu5'r BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � Permit Number:
Building Permit Application RECEIVE®
Planning and Development Services 5 10 2013
Building and Code Regulation DM51on
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial R 4 DCY, Permitting
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of line 'A
URIUAI 11110
Address: 6771 Dlcklnson Ter
Legal Description: OLEANDER PINES REPLAT BLK 1 LOT 140(0.237 AC)(OR 3339-2227)
Property Tax ID# 3415-706-0011-000-0 _ Lot No. 140
Site Plan Name: Block No.
Protect Name:Wade&Crlstlne Nettles
Setbacks Front Back: Right Side: Left Side:
4 �C..•A� �t.l�- 1 I—Grl� � c!%i'1 �� rl.�A.1 �'l���2.�'."
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Additional work o b rformea under this perm -•Check all appy:
HVAC Gas Tank OGas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator•. Roof Roof pitch
loo
Tota).Sq, Ft-of-ponstructlyp. 5 . Ft.of'&irstffse,
r:
Cogt„'Pf4opa truGYlon:$_1 5; 37.00 Utilltles: SeWerptlt ' 'Bullding Helgh't:
Name Wade&Christine Nettles Name:Jeffrey Lindstrom
Address: 6771 Dickinson Ter Company; Lindtsrom Air Conditioning
Clty: Port St Lucie State: FL Address:Jai LtI Nie a 1a �
Zip Code: 34952 Fax: City: Pompano Beach State:Fl
Phone No, 772418-7406 Zip Code: 33069 Fax:
E-Mail: Phone No. 772-600-4088
Fill in fee simple Title Holder on next page(if different E-Mail: dulcem@llndstromalr.com
from the Owner listed above) 5tate or County License: CACo5®871
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
09/10/'2018 MON 12: 3.3 FAX U00.2/002 _
11111 1111111121111
DESIGNER/ENGINEER:. Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Wade e,chdellneNemea" Name'Jeffrey UndaWn
Add ress:6771 DlddneonTer Address' 6771 DlcklnmonTer
City: PansiLuale State, City: PompenoBeach 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:___
OWNER/CONTRACTOR AFFIDVIT:Application Is hereby made to obtain a permit to-do the work and Installatlon as Indicated.
I certify that no work or installation has commenced prior to the Issuance of a permit.
St.Lucie County makes no represent tion that is granting a HAermit will authorize the permit holder to build the subject structure
Which is in conflict with any pplicab�e Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult wlt�i 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 Duilding Codes and 5t.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additlons,
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 CommenceJay result In your paying twice for
improvements to your property.A Notice of Commencement muorded and posted on the jobsite
before the first inspection, If you intend to obtain financing,con Iender or an attorney before
commencing work or recording our Notice of Commencemen .
Signature of Owner/Lessee/Contractor as Agent for ownerSign C tractor/License Holder
STATE OF FLORIDA STATE F LORIDA
COUNTY OF 454 rC.c+u COLIN OF
The for oing instru ent was acknowledged before me The forgoing Instr ent was acknowledged before me
this day❑f r 20 6y this day of 20-1 by
Name of person making statement Name of person making statement
Personally Known_OR Produc%Lj j M x x J% Personally Known OR Produced Identification
Type of Identification Pr � 06imo1 Typ oFldentification �Yp DULCEMAMEZ
roduced i� tpZgZ Pr d ced # Commis9lon#0G103391
► ,� �` Explrea MayjA L.,
10,2021
�0 i 1� kloadedTArUt3udd�ponryaerrku
(Signature of Notary Public-SNA of Florida) (Signature of Notary Pubi -Stat f Florlda)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17