HomeMy WebLinkAboutbuidling permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/11/20 Permit Number:
•
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone. (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 723 Nettles Blvd, Jensen Beach ILL
Property Tax ID #: 4502-501-0909-000-3
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Building Permit Application
Commercial Residential ✓
Replace 40 gallon electric water heater in utility closet
CONSTRUCTION INFORMATION:
Lot No. 723
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters Windows/Doors
Electric ,/Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1:3CO A
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Nameltathy Rector
Name: Lonnie Culbertson
Addre55:723 Nettles Blvd
Company -.Jensen Beach Plumbing
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.954-298-0331
Address:1086 NE Industrial Blvd
City: Jensen Beach State: FL
Zip Code: 34957 Fax: 772-225-6779
Phone No772-225-6600
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailiackie@jensenbeachplumbing.com
State or County License24654
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.
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITIJ YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
nature of Own ssee/ ntractor as Agent for Owner
Si re of Contractor/ ' e Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this J L day of Ma j 20_by
this �I— day of 20_2b by
Name of person making statement.
Name of person making statement.
Personally Known _ OR Produced Identification
Personally Known Z_ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
'gnatu Notary Public- State of Florida)
(Sigri ure of o ry Public- State of Florida )
Commission No. NOA*ic state of Florida
i�
Jaclyn F Wilson
M commission GG 275464
Comm, ission No. �1
No atap4ic State of ploy a
n F Wilson
Jaclyn
ommiss�or, GG 27`��
REVIEWS
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
E IEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
lev.277/19