HomeMy WebLinkAbout1028 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� 7/;, / Permit Number:
• ' Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: 1772) 462.1553 Fax: (772) 462-1578 Commercial Residential mooD000i
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: i
Address:
-rl Cft�✓
Property Tax I D #: ySO'x _ -0 I — 1 e2 I '-1 G r, r — / Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
I CONSTRUCTION INFORMATION: I
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
Total Sq. Ft of Construction:
c�
Cost of Construction: $ ! G v
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name r Pa. ij r 41,"c i a l a c
Address: 12 97 N= / rr 0/• ./
City: re"Se., Stater/
Zip Code: 1 �l 'l S7 Fax:
Phone No. / S f 8 ` dral 1 7UD 1
Name: John Law
Company, LaWs Electrical Service Inc,
Address:6158 NW Primm St
City: Pt St Lucie State; F1
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-Malllohnla'5t 58@aol.com
State or County License EC 13006370 29432
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,5W w more, a RECORDED Notion of Commencement Is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
MORTGAGE COMPANY: _ Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao rite ware dnv „a., ,, o •• • • �• -•
I certify that no work or installation has commenced prior to the issuance of a permit.
no
structure.
:e the permit holder to build the subject structure
or anti covenants that may restrict or prohibit such
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
commencingporK or reLutumx yuur tvuuw an wnu+i
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 17 day of k" A ✓t 20 03( by
this ]� day of . 20 by
Name of person!paking statement
OR Produced Identification
Name of person making statement
Personally Known � OR Produced identification
Personally Known
Type of Identification
Type of Identification
Produced
Produced
bf Notary Public State of Florida )
(Signatureof Notary Public State a
y,r WQ1 RACHEL N
Commission No. My COMMISSIO
DAVIS
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RACHEL M
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5,
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REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION QUEe.
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17