HomeMy WebLinkAbout837 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater S a U Permit Number:
L
Planning and Development Services
Building and Code Regulation Division
23OOVirginia Avenue, For?Pleree FL S4982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address:
Building Permit Application
Commercial Residential MxXXxxxx
v Q
Property Tax IDit: LIfU,2- S—Ol- iG---'3 OUCl-J� Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Block No.
_Mechanical
_ Gas Tank
_ Gas Piping
_ Shutters
_ Windows/Doors
_ Electric
_ Plumbing
_ Sprinklers
_ Generator
_ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ G d
Sq. Ft. of First Floor:
Utilities: —Sewer _ Sepzic
Building Height:
OWNER/LESSEE: I CONTRACTOR: i
Name Tia,M,; tt�,M,'��
Address: %
City: !';12vr -,'s vv //c State: �y
Zip Code: /211 G 2 Fax:
Phone No. /-S-/f- SL.2- a(k3
E-Mail:
Fill In fee simple Tale Holder on next page ( If different
from the Owner listed above)
Name: John Law
Company: Low's Electrical Service Inc.
Address:5158 NW Prmm St
City: Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail 10hn1aw5168sol.com
State or County License EC 13006370 29432
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 Nctice of Comrn:ncemant 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
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
_Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work ana mscai ation as In UiLdLea.
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
k r record in our Notice of Commencement
commencin or o
Signat of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
IV
The forgoing instrument was acknowledged before me
this f %— 20,A6 by
this day of �� 203( by
—day( _�
Name of person making statement
Name of person nuking statement
Personally Known T/ OR Produced Identification
Personally Known I OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature o Notary Public- State o
Public- State of Florida )
of Notary Publ
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Commission No. } \ '>
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ES January 5,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
aGVEe.c
REVIEW
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/Z/17