HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETE DFO I A APPLICATION TO BE ACCEPTED
Date: 11/18/2020 PermitNum.ber: C2- o L I - 00al
Or. I LUC, HIE,
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RuOdlng. Permit Application
p ion
Planning and Development Services
Building.ond Cbde.rkeguldt'lon Division tommercial ReMdential
MOVffiglhlcf Atiehdoll Fort Piercti FL.34982
Phone: (772)-402-1 53 Fax: (772)462457-8
PERMIT OvocATION FOR:
PRQP
OSED
E V j
Address: t%'Nettles.Blvd. Jensen:.'Beach, FL 34967
Propqirty Tax IDW-AWZ7501-Q042-000-5. 'L6t:,No.,
5ite,Plab Name: 'Block No;
, afi�e�
Project Name:,
iVE, A LEO,Qf S *Q
R,1PT10'W0FWK0 K"
Rebuild Deck (4
New Electrical M61:0 'Second decteic *qI Meter
I
r.
CONSTRUCTION ANFORM ATON
Additional Work to be performed Linder this permit -,check all that apply:.
—Mechanical GAs Tgnk Gas"Piping _Shutters —W.IndoWs/Doo,rs Pond
Electric Plumbing Gcinerator' Roof 'Pitch
Total 54. -Ft of C6nstrU6tion:,091l`-. rSq. Ft. of First'Floor:
Cost of Construction:'$ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:;
CONTRACTOR `
Name L6is M. Dick,
Name:
Company. --Larry Neese Roofing & Construction
Address :.3+01 8. US Highway 1
City; Fort Pidrce State:,FL,
Zip Code:, 84982 Fax:
Phone No (772)361-6580
AcIcifest: 126,80iset Ln
City: Culpeper State:VA—
Zip Code:: 9,2701 — F=
Phone No. (546} 111-7069-
E-Mail: gratefulgaindm6m0yahoo.com
Fill in fee simple'Title.Holder on -next page ( if different
from the Own.er listed .6bove)
E-Mail
State or County License CGC1 523983
,If value Of con. struction Is 2500 or more,�a RECORDED Notice of Commencement -IS requires.
'is required.
If value of:HAVC Is-$:7j56.o or rnore,'a RECORDED Notice of Commencement;
S.U.RFLEME.NTAL:CO,`NSTRU'CTION LIEN LAW,LNFORMAT(ON_
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:' Not Applicable
Name: )VC, P" lnD114
4-ckler n.,; n.Names
_
Address:
Address. 9 I, (2e t r ytry e, Aye • _ _
City: 4. Pittr"T
� ,State: l---
City: State:
Zip: Phone '7-!L'I-lid
— t-?'1 .•1
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _'Not
Applicable
BONDING..COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
:City:
Zip: Phone:
Zip: Phone..
OWNER/'CONTRACTOR AFFIDVI,T: Application"''hereby made to obtain'a per' t�to do the work and installation as_Indicated.
11certify that no work,or-installatiowhas commenced prior,to the issuance.,of a permit.
to'build the
In consideration of theVanting 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 1301ding°Codes.and St. Lucie'County-Arrieridments..
The, foliowing:building permit applications are exempffrom undergoing.a full concurrency review,• room additions,.
accessory -structures; -swimming pools, fences,'walls, signs, screen rooms and i ccessorywes to -another non-residential use
WARNING TO -OWNER Your,failure to Record a Notice of°C a- result,.in paying twice;for
Improvements t6 your property. A Notice of Comrnen en,t must be re rcle in the.,public r t:
L oun y �!posted,on,the �obsite be first tns`p If nd to obtai ancing, consulf
' h lender.or'ad orneV befo m'enciniz work or:rec ce;of Co encement:
Signature of Owner/1."esse` o ractor as Agent for Owner
Signature of Contractor/License Hol er
STATE OFFLO DQQ
STATE OF FLO
COUNTY OF'{ �_l iCA
COUNTY OF . C.t•P
Sworh.t-or.affirmed) and subscribed;before nie of
Sworn to (or affirmed) arid subscribed before me.of
✓F ysical Pres nce or Online'Notariiation
_202o
sical P"re. a ce or Online Notarization
this 'r`dayof by
this ay of 2020 by
t
Name of perso A�=R
Nmperson king -sate.
Personally Knownduced Identification
Personally Known. OR Produced identification
Type of Identification
Type of Identification
Pro_Ur
d ,,)
YI sal�Q'. n AL.C11'�VAs
Pro ced
(Signature'of Nota Public -'State of Florida')
(Signature qf. NotaryRublic- State of'Florida }
Commission No. 0 a./ 9c_JP (Seal)
Commission Nov CN /aS (0 (Se
) +s'%
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DATE
RECEIVED
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DATE,
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COMPLETED
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