HomeMy WebLinkAbout223 nettles permitAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 6 a0 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia A venue, fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential °O°0000�
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 2 N,— H17%r
Property Tax ID f{: L/ J—C/ — S-A' I — G C7 q — U G G — Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
/� 1
/ rr file /7—
7a—CONSTRUCTION
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: $ 1.k0 U GUtilities: _Sewer _Septic Building Height;
OWNER/LESSEE:
CONTRACTOR;
Name L UY L da- t3i1.^ f
�Name;_Joh` Law
'Elecrical Service Inc.
Company: Laws
Address:
City: State: �% I
Address:5158 NW Prmm St
City; Pt St Lucie State: FI
Zip Code: / —f 7 T 7 Fax:
Phone No. 7 (o S—
Zip Code: 34983 Fax:
E -Mail:
Phone No 772 370 4357
Fill In fee simple Title Holder on next page ( If different
E-Maillohnlaw5158920l.com
State or County License EC 13006370 29432
i
from the Owner listed above)
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 Native of Crmmencement 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:
City:
Address:
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 pPermit will authorize the permit holder to build the subject structure
which Is In con Ict with an 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
commencine work or recording your Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing Instrument was acknowledged before me
this_I dayof 76✓1c 20-'Wby
Name of person making statement
Personally Known T/ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State o ,�
_ t "a�{►
Commission No.
uon �eaalsa
REVIEWS
Rev.
FRONT I ZONING
COUNTER REVIEW
STATE OF FLORIDA
COUNTY OF
The for Ing instrument was acknowledged before me
this:Tday of '.Tv—'c , 20 apby
Name of person Taking statement
Personally Known OR Produced Identification
Type of Identification
Produced
of Notary Public -State of
RACHEL DAVIS
My COMMIS
SIO ;MF"*0 No.
EXPIRES Janu ry 5, 2019
SUPERVISORI PLANS IVEGETATION
REVIEW I REVIEW I REVIEW
REVIEW I REVIEW
F•,.
RACHEL M DA
1
'[ MY COMMISSION#FF1
7
1
I January 5,
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REVIEW I REVIEW