HomeMy WebLinkAboutNettles permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/7/2020 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 48 nettles blvd., Jensen Beach, FL 34957
Legal Description: Nettles Island
Property Tax ID #: 4502-501-0234-000-0
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Running new feed to condenser unit in front of building. Using existing breakers. r/Li
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional wor to a per orme un er t �s permit — c ec a app y:
❑HVAC Gas Tank FIGas Piping Ll Shutters windows/Doors
IzElectric Plumbing Sprinklers E Generator Roof Roof pitch
Total Sq. Ft of Construction: S. of First Floor:
Cost of Construction: $ $1300.00 Utilities: Sewer 11 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Christine Lohmeyer (new owner) Name. Keith Thompson
Address: 15980 SW 13th Street Company: AC Keith Inc.
City: Penbrooke Pines State:FL Address:
Zip Code: 33027 Fax: nla City: Port St Lucie State: FL
Phone No. 954-410-2518 Zip Code: 34953 Fax:
n/a
E -Mail: Phone No. 772-519-1351
Fill in fee simple Title Holder on next page ( if different E -Mail: ackeithl@att.net
from the Owner listed above) State or County License: EC13009417
If value of construction is $2500 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 thepermit 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, l do hereby agree that 1 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
comj:0QncWng work or recurin our Notice of Commence t.
ignature of Owner/ ess7-/—/,-
actor as Agent for Owner Signature of Contrac or se Holder
STATE OF FLORIDA , STATE OF FLORIDA
COUNTY OF _S `e- COUNTY OF �� z
The forgoing instrument was acknowledged before me Theforgoing instrument was acknowledged before me
this '7 day of 19c� J J 20 ,u by this 7 day of 202-,;' by
Name of person making statement;� Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced /"l_ '�' e- Produced —/ _ -
alLI
(Signature of Notary Public- State of
Commission No. Jo 13
REVIEWS I FRONTZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
PHYLLIS ANN D A1,MS is
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My Comm. Expires A g B, 2023
of Notary Public- State o
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SUPERVISOR
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