HomeMy WebLinkAbout360 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ - RG Permit Number:
I � W
`~ Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierre FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential xxxxxxxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: r� t✓�
Property Tax ID #: yS b a — .S o I — C'SS 41 6 — 00 & 0
Site Plan Name:
Project
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
—Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
o�
Cost of Construction: $ . / % SU
_ Gas Piping
_ Sprinklers
Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Lot No.
Block No.
—Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name E W 4r,•C iYl v. r �z
Name:3ohn Law
Company, Law's Electrical Service Inc.
Address:5158 NW Primm St
Address: 444 L o c c k ely z
City: / U r sue_ Jqr'� State: &T
Zip Code: C� ] •7 6 4/ Fax:
City: Pt St Lucie State: FI
Phone No. �l O8 R �S�' 7 U LE
Zip Code: 34993 Fax:
Phone No 772 370 4317
E-Mail:
Fill In fee simple Tide Holder on next page ( if different
from the Owner listed above)
E-MailJohnlaw5158@aoi.com
State or County license EC 13006370 20432
if Value of construction Is $iSOO Or more, a RECUKMU Notice Or LOmmen"nJEJ1L. i6gU. c.+•
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required-
rt 1nn1 r e 0r.]Y A I / N ftjr Tn I il`T1l9wr 1If RI1 AL A l l wIYlU] A A A TInhl.
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
State:
City: State:
City:
Tin- PhnnP I
To: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIOVIT: 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 permit holder to build the subject structure
is in with applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
which conflict any
structure. Please consult with Pyour Home Owners Association and review your deed for any restrictions which may apply.
Inconsideration of the granting of tnls requested permit, i do hereby agree Lndi i will, m di. N=� :�� ��� _ xark
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
IV-
before the tirst inspection. It you Intend to obtain financing, consuit wiin 6r16CI ul dI I dUut 1 icy vl c
commencing ork or recordin our Notice of Commencement.
6t-a
—(J�
signat jTe of Owner/ Lee sseeO/CoCo ntractor as Agent for Owner
i Signature of nntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
f
The forgoing instrument was acknowledged before me
t Al by
The forgoing instrument was acknowledged before me
this gdp day of do& ,• 1 .20AJ by
this �Foday of dpr, , 20
Name of person king statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
I
I
ubhc State of Florida)
ISignature of Notary Public- State
RAC14EL
DAVIS
COmmi55ign No. `-?-'�� ^`��
M.y GOMNq•�
711.�
-"CHEL M DA
EXPIRES Janu
ry 5, 2919
S MY COMMISSION eFFt
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7
1407) M 015.7 FloridaN ma 5
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATIONS
REVIEW
m
REVIEW
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
i
DATE
CUMA Lt i tU
Rev.8/2/17