HomeMy WebLinkAbout124 nettles permitAll
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Lode Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE:
Residential xx00000'
I PROPOSED IMPROVEMENT LOCATION: _ I
Address:
f✓
Property Tax ID #: y-so A- SG f G j d G GG 7 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Existing Meter pedestal
CONSTRUCTION INFORMATION':
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:
G✓
Cost of Construction: $ / 9 c/o
_ Windows/Doors
Generator Roof Pitch
Sq. Ft. of First Floor
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE;
CONTRACTOR:
Name ?ay7.c*,gmre k3er, h r� t
Name: John Law
Address: / 2 L/ /t c n / c r/
Com pang: Laws Electrical Service Inc.
City: 't",- h C ovi %3 e.4 c 1, State: _1�?
Zip Code: L/� S % Fax:
Phone No. 7 7), - % 1 S' O �L (b S
Address:5158 NW Primm St
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-Maiijohnlaw515B@aol.com
State or County License EC 13006370 29432
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requuea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
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 Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to oo the worK ano nrDtCO>.,u,
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County make 5 no representation that Is granting a permit will aut orize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, by�aws 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
_i- _—..Ji., r N..+ire _f !•n .m ,nmcnt
CoMrnenLiriX,VvuiK ui iulujull in yuu-
f�
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 foToing instrument was acknowledged before me
by
this! Fday of T��' c- , 202/ by
this t day of �� c . 20a t
Name of person king statement
ma
Personally Known OR Produced Identification
Name of person m king statement
Known OR Produced Identification
Personally _ y��
Type of Identification
Type of Identification
Produced
Produced
i; ' l �'1 {• �' !l� I d f
yy- J F r f � j•i Fes___
(Signature of Notary Public- State o
bf Notary Public State of Florida)
w`. RACHEL
DAVIS
Commission No. ` ;- i MY COMMISSIO
dr EXPIRES Janu
gppW4&
ry 5, 2019
No.
f:°•"-"'c;�_ RACHEL M DA
CO
MY MMISSION #FF1
•`�-.
p0?i 3UBfiFl t53 oridallota 5
ce
rvl.com
.'-�
pr• ,,,� January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION &GV&.c
COUNTER REVIEW REVIEW
REVIEW
REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17