HomeMy WebLinkAbout1001 Nettels Blvd permit app ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date
k ids' 'N,: -
- 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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
IL\ (LO
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Legal
Description:
-n�v-F
Lot No.
Property Tax ID#: `I �( `�
Block No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED [DESCRIPTION OF WORK:
n
CONSTRUCTION INFORMATION:
Additionalwor to e e m ore un ert is permit—c ec a Kapp t
OHVAC Gas Tank Gas Piping —Shutters Windows/Doors
0 Electric Plumbing oSprinklers El Generator Roof Roof pitch
Total Sq. Ft of Construction: SCI. Ft.of First Floor:
Cost of Construction:$ Utilities:0Sewer 7Septic Building Height:
OW N ERAESSEE: CONTRACTOR:
Name
Name: JOSEPH F TULLY
Address:
Company: GENESIS PLUMBING SERVICES INC
City:
State:- Address: 1532 SE VILLAGE GREEN DRIVE UNIT B
FL
Fax: City: PORT ST LUCIE State:
Zip Code ( I' ra Zip Code: 34952 Fax: 772-335-2680
Phone No 772-337-3682
E-Mail: Phone No.
Fill in gee simple Title Holder on next page{if different E-Mail: genesispiumbingservices@gmaii.com
from the Owner listed above)
State or County License: CFC1429103
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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
commencing work or recording our Notice of Commencement.
Signature of Owner/ Contractor as Agent for Owner ignature of Contractdr/License'R'o]der
STATE OF FLORIDA. STATE OF FLORIDA {-
COUNTY OF 'I- ? COUNTY OF � � ,3
The forgoing instrument was acknowledged.hefore me The forgoing instrument was acknowledged,before me
this, �=day of ,`°° ... 20 _''by this:-''- day of ` t 20 by
(Name of person acknowledging) (Name of person acknowledging)
yy�
(Signatuf—e-ff Notary Publio-State of Florida (Signature of Notary Public-State of Florida )
"`y,,. Prc�ehRiPoieMtf �i Personal) Known -' o+= '
Personally Known >.�.,gr' j Z y d}i Prq �,dp�tet>aMrc t42f Z
Type of Identificati Y°TJ Commission#GG 97150 Type of Identificati °o °ad Commission#GG 97150
o� y ommission twres, sty commission xpires
, „� Aprl 24 202
Commission No
1 or4 gprll 021
Commission No. . f++
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS