HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7-22-2020 Permit Number:
CJ1c LUCIELF R
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Add a new Covered 4 wall patio
PROPOSED IMPROVEMENT LOCATION:
Address: 161 Nettles Blvd.
Property Tax ID #: 4502-501-0347-000-5
Site Plan Name:
Project Name: Nettles Islands
DETAILED DESCRIPTION OF WORK:
Build a new wood 4wall covered patio
New Electrical Meter N/A Second Electrical Meter
CONSTRUCTION INFORMATION:
12
Lot No.161
Block No.
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors _ Pond
_ Electric _ Plumbing Sprinklers _ Generator _ Roof 2112 Pitch
Total Sq. Ft of Construction: 276 5Q•FT• Sq. Ft. of First Floor: 276 SQ.FT.
Cost of Construction: $ Utilities: _ Sewer —Septic Building Height: 15'-8"
OWNER/LESSEE:
CONTRACTOR.
Name Gerald Bashant
Name: Lee D Palmer
Address:161 Nettles Blvd.
Company: Palmer Construction Inc.
City: Jensen Beach State: _
Zip Code:34957 Fax:
Phone No. 772-240-4995
Address: P.O. Box 621
City: Palm City State: FL
Zip Code: 34991 Fax: 772 287 1239
Phone No 772 287 1239
E-Mail: Jer35greef@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Maildlpaimer99@gmail.com
State or County License CGCA05605
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: •-4o-n tk -1 Fo0FWSKS
MORTGAGE COMPANY: Not Applicable
Name:
Address: 72S S. o -. Fep
4we.1es 1&-4o
Address:
City: T orz` - S-r• C. JG le—
Zip: 3417gE�-.I Phone -7'12
State: -pe-
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
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 Horne 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. if you intend to obtain financing, consult
with lender or an attorney beforg'kommencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee Contractor as Agent for Owner
Si re of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLO
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COUNTY OF '/'
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Swor to (or affirmed) and subscribed before me of
K Physical Presence or Online Notarization
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Ph sicaI Presence or Online Notarization
this day of i 2020 by
this day of 2020 by
Name of person making statement.
Name of person making statement-
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Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Pr ed
Pru ed
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Notary Public -State of Florida
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Commission Np.
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