HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: -b(z)
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 TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 83 nettles blvd jensen beach fl 34957
Property Tax ID#: 4502-501-0269-000-1 Lot No.83
Site Plan Name: nettles island Block No.
Project Name:
DETAILED DESCRIPTION OF WORK
demo of ry mobile home and concrete
CONSTRUCTION INFORMATION:-�` ��=� -�'"
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ qbD Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTOR:.
Name wiersema Name:roobert smith
Address:83 nettles blvd Company:smithomes inc
City: Jensen beach State:_ Address:2903 industrial ave two
Zip Code: 34957 Fax: City: ft pierce State:fl
Phone No. Zip Code: 34946 Fax:
E-Mail: Phone No 772-461-9222
Fill in fee simple Title Holder on next page(if different E-Mail' N,
from the Owner listed above) State or County License
crc005706
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW-INFC►RMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF \,acs eCOUNTY OF
The fo�going instrument was acknowledgpd before me The fo%ping instrument was acknowledge efore me
thiA_'�-) day of C 2by this day of RQ�-\_ ,2y
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known/VstOR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public (Signature of Notary [ Late Qfo iaba y GG 2e1062
r"v�• STELLA M HUNTER
My Comm.Expires Jan 23,2023
°r° 4�=. ublic-State of Florida
Commission No. ' -«' COmmi55ion No. Bonded through N N otary Assn.
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My Comm.Expires Jan 23,2023
National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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