HomeMy WebLinkAbout1088 nettlesALL APPLICABLE INFO 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
Address: 1P %(•'C—
Legal Description: —
Property Tax ID #: 6- ^(J 2 ..S c' ( 0, 7 E 0C Lot No._
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONOF WORK:'
-eL -e:�.S 11
CONSTRUCTION INFORMATION:
CONTRACTOR: _
Name h 4 HI /-r c-' P+% ". a r
Address: 923 L✓✓, cuzr Aye
City: Sc % 2 � � � f.�., State:
Zip Code: 0, .30 Fax:
Phone No.
_
orme un ert ispermit—c
Additional work to ff
ec a appy:
Q
HVAC Gas Tank
❑Gas Piping
_ Shutters
Windows/Doors
Electric 0 Plumbing
Sprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction:
r
S . Ft. of First Floor:
OSeptic
_
Cost of Construction: $ % �-co
Utilities:
Sewer
Building Height:
OWNERAESSEE:
CONTRACTOR: _
Name h 4 HI /-r c-' P+% ". a r
Address: 923 L✓✓, cuzr Aye
City: Sc % 2 � � � f.�., State:
Zip Code: 0, .30 Fax:
Phone No.
Name: John R Law —
Company: Law's Electrical Service Inc. —
Address: 5158 NW F'rimm St
—
City: Pt ST Lucie State: FL -
Zip Code: 34993 Fax: —
Phone No. 772 370 4357 —
E -Mail: johnlaw5158@aol.com —
State or County License: 29432 —
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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:
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 lender or an attorney before
commencin ork or recording our Notice of Commencement. Signatuk of Owner/ Lessee/Contractor as Agent for Owner Signature 0� ontractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before meThe forgoing instrument was acknowledged before me
-
this f day of M 1 '1 , 20 l `1 by I this I day of W _1.-,; 11 , 20_L1 by
Name of person making statement
Personally Known 3 OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State
Commission No 5
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
393-0153
FRONT I ZONING
COUNTER REVIEW
Name of person making statement
Personally Known_ OR Produced Identification
Type of Identification
Produced
2 � _ --
64='_-=;of Notary Public- State of Florida )
RACHELDAVIS
MY COMMISSIO #I�m�?io No. t t
EXPIRES Janu ry 5, 2019
SUPERVISORI PLANS VEGETATION
REVIEW REVIEW REVIEW
RACHEL M DA'
MY COMMISSION #FF1
REVIEW I R
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