HomeMy WebLinkAbout2148 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: —V�L— Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981 Residential t
Phone: (772) 462-1553 Fax: (772) 462-1578 Commel`tlal
PERMITTYPE:
PROPOSED
LOCATION:
Address: 21 i'1 r% / Za- l-tl ri 47 L c/
O/
Lot No.
Property Tax ID #: G/� G.� �� / —
Block 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:
_Mechanical _Gas Tank _Gas Piping _Shutters _
Windows/Doors
Electric Plumbing Sprinklers —
Generator Roof Pitch
_ — _ 5 P �
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
ad
Cost of Construction:.$ � utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
Address:
City, State:�S
Zip Code: G 8 3 I Fax:
Phone No.
E-Mail:
FIN in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name•John Law
Corr, pa my:Law's Electrical Service Inc.
Address:5158 NW Primm St
City,: Pt St Lucie State: Fl
Zip Code. 34983 _ Fax:
Phone No 772 370 4357
E-Mailfohnlaw5158Qo aol.c0m
State or County Licensa EC 13006370 2a432
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,SCi0 or more, a RECORDED Notice of Commencement Is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
MORTGAGE COMPANY: — Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: 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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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
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LVIIIInC11L111 VI a, VI ICI. ......-....-......-.
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�dayof oj?., 20� by
thisX-dayof� " 1 .20-al by
Name of person king statement
Name of person making statement
Personally Known s ZOR Produced Identification
Personally Known _ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
lignature of Notary Public State o
of Notary Public State of Florida I
RACHEL
DAVIS
Commission No. Vy� i 5 �\ a. ''s MY COMMISSIO
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No I ` i A s+...� .
RACHEL
�'
EXPIRES Janu
ry 5, 2019
M DA\
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(aav) 3WB 153 Floridallotary
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! ES January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION R®idEe.c
REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
!
COMPLETED
Rev.8/2/17