HomeMy WebLinkAbout2071 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 v 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 xxxxxxxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: A 0 ?/ /V z YlrJ t7l v"l
Property Tax ID #: —o l — G o 7 `Y — 0 09 -- i _ Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Block No.
_Mechanical
_ Gas Tank
_ Gas Piping
_ Shutters
_ Windows/Doors
_ Electric
_ Plumbing
_ Sprinklers
_ Generator
_ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ / ,lau a✓
Sq. Ft, of First Floor:
utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name !%o-N d- Tr..Jac . 12-ecldc
Address:.2 3 E Ns lid/sJ Af%�
City: 'T-7 r c" 13T�fc < State: l
Zip Code: 3 c/ 9 S' 7 Fax:
Phone No. L_9 S_y — 3 `f 1 — 371 T
Name:John Law
Company: Law's Electrical Service Inc.
Address:5158 NW Primm St
City: Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail:
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Mailjohnlaw5158@aoi.com
State or County License EC 13006370 29432
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 Notice of Commencement is required.
[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
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not
Address:
Zip; Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to 00 me wU, R C-,U ---------
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 ano 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
commencing,livol7K Or rULUIU I 119 YULI I\uuw nu,n ,,
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
0 2020by
this-ILdayof 17rC 2oAsby
this __9_ day of
Name of person king statement
Personally Known person
Produced Identification
Name of person milking statement
Personally Known OR Produced Identification
_
Type of Identification
Type of Identification
Produc'edd��
Produced
f Notary Public State of Florida )
{Signature of Notary Public State o
M,r RACHEL
DAVIS
Commission No. 4 �`+`_: i S3� ' MY COMMISSIO
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RACHEL M DA
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I S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION RSdEe.c
REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17