HomeMy WebLinkAbout752 NettlesAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical - Panel Change
PROPOSED IMPROVEMENT LOCATION:
Address: 752 NETTLES BLVD, Jensen Beach, FL
Property Tax ID 4: 4502-501-0938-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Marietta Kamin
DETAILED DESCRIPTION OF WORK:
Panel replacement and service change
New Electrical Meter —Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical —Gas Tank —Gas Piping _Shutters Windows/Doors W Pond
ElectricPlumbing —Sprinklers __.. Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2005.42 Utllit[es: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Marietta Kamin
Name: Donald Green
Address: 531 Essex Ave
Company: Don Green Electric
City: Gloucester, MA State:
Zip Code: 01930 Fax:
Phone No. (978) 283-7209
Address:1305 W 1st St
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No (772) 418-5739
E-Mail: mariettakamin@aol,com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Permits(Pdongreenelectric.com
State or County License EC13007447
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required.
If value of HAVC is $7,500 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 TITLEHOLDER: _ Not Applicable
Name:
Address:
City:
BONDING COMPANY: —Not Applicable
Name:
Address: _
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 ppermit 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
wi{ii 1pnripr nr do attnrnpv hpfnrp rornmPncine work or recouVne vour Notiat of Commencement.
Signat re of Contractor/IContrartor/I icenTie-ITolder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF B Warci
COUNTY OF
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