HomeMy WebLinkAbout538 nettles permitAll APPLICAB INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -� % Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
230a Virginia Avenue, fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
IMPROVEMENT
Address:
e- /-f / r
Property Tax ID#: 4"111 -�-G.2-- -Cc, / - U 7,2,'-I _ CCUa - 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:
—Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
'f`
_ Gas Piping
_ Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor: _
Utilitles: _Sender _Septic
OWNER/LESSEE: I CONTRACTOR:
Name //y,//.4. ,,_ /_-re,:- SvY,L
Address: 3 '/ v? 4y , 1 a-7 c
City: Sc In State: JLC
Zip Code: /.Z S v 7 Fax:
Phone No. / - -T l /i- - 3 7 to - (-I Sk 2
E•Mail:
P111 in fee simple Thle Holder on next page ( if different
from the Owner listed above)
Block No.
Windows/Doors
Root Pitch
Building Height:
Name; John Law
Company: LaWs Electrical Service Inc.
Address:5158 NW Primm St
City: Pt St Lucie State:.FL.'
Zip Code: 34983 Fax:
Phone No 772 370 43P
E-Mail Johnlaw5158@ao1.com
State or County License EG 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 Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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
..F r'n nrumnn4
1.V 111111CIIU11 VI1� VI IGAVI uuI uu, ........................
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
The forgoing Instrument was acknowledged before me
this Z day of kn,4 . 20: v by
this X? day of /"ii . 204L� by
Name of person making statement
Name of person making statement
OR Produced Identification
Personally Known _,zi' OR Produced Identification
Personally Known _L
Type of Identification
Type of Identification
Produced
Produced
'
(Signature of Notary Public- State o
of Notary Public- State of Florida j
RACHEL N
DAVIS
Commission No. ;E` _
�� ta!d1 My o0MMl8Sl0
gppR *Oo
No. RACHEL M DA
�:owM1l EXPIRES January
".•...•..•�
5, 2019
-' 'p My COMMISSION #FF1
(407) 3N.0153 Flormlallotary
NICe.CURI
EXFrIRE5
January 5,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
9VEe.
REVIEW
REVIE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17