HomeMy WebLinkAbout634 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: v Permit Number:
': Building Permit Application
Planning and Deve/opmentServices
Building and Code Regulation Divls/on
2300 Virginia Avenue, Port Pierce FL 34M2
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 1O0022oa
PERMIT TYPE:
Address:
-ri
Property Tax ID #: Z .� O,;- - S-O / - OS.Z O - GOO - S
Site Plan Name:
Protect Name:
DETAILED DESCRIPTION OF WORK:
lor
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank
_ Electric _ Plumbing
Total Sq. Ft of Construction:
(� U
cost of Construction: $ /. -) iro
—Gas Piping
_Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Lot No.
Block No.
Windows/Doors
Roof Pttch
Building Height:
OWNERAESSEE: I CONTRACTOR: I
Name 0 -t r
Address: l 3 `f /V a H I rj 131
City: [ , t t3 rr t^ State: C(
Zip Code: 3 7ti S Fax:
Phone No. 2I L
E•Mail,
Fill in tee simple This Voider on next page ( If different
from the Owner listed above)
Name;John Law
Company: LaWs Eledricel 3arvlce Inc.
Address:5158 NW Primm St
City: Pt St Lucie State: Fl
Zip Code: 34M Fax:
Phone No 772 3T0 4357
E-Mail10b"I"W6166CO"t.com
State or County License EC 13006370 29432
If value of construction Is $2500 or mare, a RECORDED Notice of commencement If M
If value of HVAC B $7,W or more, a RECORDED Naft of Commencement Is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
—--- ------• ------------
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT! Application is hereby made to obtain a permit to 0o the worn ono
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
N ' f C m ncement
commencen ork or recordingour once o om e
n
Signati of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontractor/L1iceense 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
7� 20 2uby
this 3 v day of T�.ti a . 20;;tr,by
this day of +�- .
Name of person making statement
OR Produced Identification
Name of person making statement
Personally Known OR Produced Identification
Personally Known
Type of Identification
Type of Identification
Produced
Produced
i
of Notary Public State of Florida)
DAVIS
(Signature of Notary Public- State o
r .. RACHEL N
Commission No. V \ t' a My COMMSSsio
%R 310 No. RACHEL M DA
�d EXPIRES Janu
?urn t'
try 5. 2019'
My COMMISSION #FF1
(407)3U8-0153 Floridallotary
Nice.com-�
.,,yaw.!' I January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION d91iEa_°
REVIEW REVIE
COUNTER REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17