HomeMy WebLinkAbout1392 nettles permitALL APPUCABLE INFO MUST BE COMPLErED FOR AMICATIOi TO BE ACCEPTED
Date: �30 Permit Number_
•. Building Permit Application
Planning and Development Services
Building and We Regulation tbuision
2300 viry w Avenue, Fwt Pierce FL 34M
Phone: (772) 4b2-1553 Fax: (772) 4Q-WS Commercial Residential x mxK
PERMIT APPLICATION FOR: To Seled from dropbcm dick arrow at the and of fine _ �11
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Address:
Legal Description:
Property Tax IDfk '-/S-O A- 57O/- I-C79- GlJy^ 7 Lawo.
Site Plan Name:
Block No.
Project Name'
Setbacks Front Bads Right Side- Left Side:
777777777
lrna f« 0 ko',C-''c
Total Sq. Ft of Construction: Ft of First Floor:
Cost of Construction: $ so r) av UtiGtmw Sewer [3SepbC Budding Height
OWNER/LESSEE: "
CONTRACTOR.
Name .lcJl�v. d- i', k"Arg_1sdcsry-e,
Name: John R Low
Company. Laws Elagrloel Service Inc
Address: 5158 NW Pdmm St
Address / 3 /
City: . ! ey S c� r3 rAo G, State: �/
Zip Code: 3 `"/ cl C i Faoc
Phone No. I - 7 3 7- 21
Crty: PT ST Line state: FL
ZIP Code: 349ss Fax:
Phone No. 772 370 4357
E-Maik johnlow5158QaoLcom
State or County License: 2 9432
E-Mail:
Fill in fee sinnpie Tltfe Holder on next page (ff different
from the Owner listed above)
if value of construction U SLUD or core, a RECORDED Notice of Comnnenaanwrtis required.
[SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Not
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 Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is nerecy mace to oocatn a pei nu. LV �� o • ••--••__._.. __ ..._.___
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 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
f C cement
nc commein ork or recording our Notice o ommen
Signature of ontractor/License Holder
Signat of Ownei/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
0eC 207CJ by
this TV day of J✓_ -rs__ 2D 2c�by
this day of ,
Name of person king statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known Produced Identification
_4OR
Type of Identification
Type of Identification
Produced
Produced
of Notary Public state of Florida I
(Signature of Notary Public- State o
RAC
DAVIS
Commission No. i`F—; 5=>l a!1-
- MY COMMISSIO
9PFlOJO
No. F x
RACHEL M DA
EXPIRES Janu
ry 5, 2019
MY COMMISSION #FFi
(<o]) 36"l 53 Flariaallotary
1`0 a-Com
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION BAbiEe.°
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17