HomeMy WebLinkAbout203 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; S 1 3�� I Permit Number:
. Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34H82
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential vx}Q0m
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 07,0 -3 a 1 a
Property Tax ID #; /-/ SO - SO I - 0 3 f i - G o C. - ( 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 ail that apply:
Block No.
_Mechanical
_ Gas Tank
_ Gas Piping
_ Shutters
-Windows/Doors
_ Electric
_ Plumbing
_ Sprinklers
_ Generator
—Roof Pitch
Total Sq. Ft of Construction:
u ✓
Cost of Construction: $ / Cl.I-U
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
I CONTRACTOR:
Name /+mar, d- fr.o 11-1-7 t�r.L
Address; S-00 Mro
City: Oq f/-e og c 16 0 State: &(f
Zip Code: 1 ? (& (,9c) - Fax:
Phone No. / - 31 S-- 3.A 3 - 3 I S- 9
Name; Sohn Law
Company, Law'sElectrical Service Inc.
Address:5158 NW Primm St
City; Pt St Lucie State: Ff
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail:
fill in fee simple Tide Holder on next page ( If different
from the Owner listed above)
E-Maillohniaw5158@aol.com
State or County license EC 13006370 29432
If value of construction is $25rm or more, a RECORDED Notice of Commencement is requires.
if value of HVAC Is $7,S00 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 Counri 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
mmnn rind urnrlr nr rprnrrling vniir Nntirp of rnmmpnrpmpnt_
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Signatyd of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The f$Qing instrument was acknowledged before me
The foVng instrument was acknowledge before me
1"'7f! r by
this s day of 14141 20 —1 by
this day of .20
Name of person m Fking statement
Name of person king statement
Personally Known iZOR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State o
f Notary Public State of Florida )
RAC]EFNG.�
Commission No. �} `r- \ - i i+.-�
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MYCOM
d' EXPIRE
,+�k°RACHEL M DA1390-MYCOMMISSION#FF7
i0W13ae-0153 Floritl
t5`.. .'
.,,,, a.� ^ 1 S January 5,
REVIEWS FRONT ZONING
SUPERVISOR PLANS VEGETATION 1 SYEe.o
COUNTER REVIEW
REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
i
COMPLETED
Rev.8/2/17