HomeMy WebLinkAboutnettles pool permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1a / a G Permit Number:
Building Permit Application
Planning and Development Services
Butlding and Lode Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentiai
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: ,_ C fo l S OC r 4 n 0 E L
Property Tax ID #: 4-1_5 0A - ,S—a l — � v O U _ G C, ry�U Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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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:
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Cost of Construction: $ 0 U
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name U�ulov. ✓tr-rso. fs ?, /Ve Nlr. �sl
Afame:John Law
Address: J/ J'O / S OCra k V &
Company: Law's Electrical Service Inc.
City: -Tc 64 Sc a f9 e .t-" State: /�
Address:5158 NW Primm St
Zip Code: 3 L/ ci S7 Fax:
City: Pt St Lucie State: FI
Phone No. 7-79 - 0130
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail:
E-Mailjohnlaw5158@aol.com
Fill in fee simple Tltie Holder on next page ( if different
State or County License EC 13006370 29432
from the Owner listed above)
If value of Construction is $2500 or more, a RELuKuty riot ICe or Lammencemcn• ,a ,CM. --
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
MORTGAGE COMPANY: _ Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIOVIT: Application is hereby made to obtain a permit to oo the wun CIiU e
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 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
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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 I day of p<c 20f,by
this I day of p<G 20LOby
Name of person m king statement
Identification
Name of person king statement
Personally Known OR Produced Identification
Personally Known _ OR Produced
Type of Identification
Type of Identification
Produced
Produced
ISlgnature of Notary Public- State o
bf Notary Public State of Florida I
,t.r `• RACHEL NI
DAVIS
Commission No. t N<- i S � MY COMMISSIO
Plml @1331
No. �
`°off.
�>'-
� EXPIRES January
5, 2019
• --, RACHEL M DA
-^ My COMMISSION #FFt
S. '
prsvl ale-0153 Floritlallotary
rvice.crom
S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION i>:1fEe.
COUNTER REVIEW REVIEW
REVIEW
REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17