HomeMy WebLinkAbout1065 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SJf7b—/_ Permit Number:
Permit Building Pe Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
I PROPOSED IMPROVEMENT LOCATION: _
Address:
C %%/ T.J
Property Tax ID ft: 1Y S - 0 ;2- 0 .S 2 —G G G - Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
Block No.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit -check all that apply:
—Mechanical —Gas Tank —Gas Piping _Shutters
— Electric _ Plumbing —Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ l .%U U
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _, Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ai - �'(1 wv jsI
Name:John Law
Address: / 0 69 tl /�. HIT.
Company: Law's Electrical Service Inc.
Address:5158 NW Primm St
City: fir. a -r c State: F1
Zip Code: -9 `'l -'2 S_7 Fax:
Phone No. 3 (0 3
City: Pt St Lucie State;FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail:
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Mailjohn1aw5158@aol.com
State or County License EC 13006370 29432
If value of construttion Is $2500 or more, a RECORDED Notice of Commencement Is required.
If value of HVAC is $7,500 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
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Address:
City: State:
Zip: Phone:
BONDING COMPANY: —Not
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to ootam a permit moo cite rr�,w a --•
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes novrepres tation that is granting a permit will authorize the permit holder to build the subject structure
which
ucctture. Plea ecconsult w7thpyollur Hlome ownOwners
rs Associa Association rules,
urr deed a any rrestnvenants itionsawrestrictiapplyhibit such
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, wails, 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
commencing,worr or rewr unris Yuuf nuwwc
14
Signatu 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
by
The forgoing instrument was acknowledged before me
this l day of , 2o� by
this LZ day of _iQQ 4 20�(
I
Name of person making statement
Personally Known : % OR Produced Identification
Name of person m king statement
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
bf Notary Public State of Florida )
(Signature of Notary Public State o
i" RACHE:L
DAMS
Commission No, i- V E ?\ a My Co1.7Missfo
�9
9A0WJWo i No } ; K
° RACHEL M DA
EXPIRES Janu
ry 5. 2019 •= VYCObtM'SSION #FFfi
(407) Sae-0153 Flwldallotary
ivice.mm
S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION use
REVIEW REVIE
COUNTER REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17