HomeMy WebLinkAbout1132 nettlesAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ZI &/A I Permit Number:
1 4
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxxxxxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: lI 2 .2 N6 L'J /1/
Property Tax ID p: 1--1T o 2— 1-0 1 — 1 3 1 `'1 — 000 ` '7 Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
'e-
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq, Ft of Construction:
Cost of Construction: $
_ Gas Piping
Sprinklers
Shutters
_ Generator
Sq. Ft, of First Floor: _
Utilities: _Sewer _Septic
Black No.
Windows/Doors
Roof Pitch
Building Height: -
OWNERAESSEE:
I CONTRACTOR:
Name F�r r-f .t 1},+%rz a
Name: John Law
Company, Laws Electrical Service Inc.
Address:5158 NW Primm St
Address: 11 3.2 ie #li' g 1511-1
CitV: TCnscn 1294,r.t, State: /--/
Zip Code: ? cl %S' 7 Fax:
Phone No. 1 ^
City: Pt St Lucie State: FI
Zip Code:3`983 Fax:
Phone No 772 370 4357
E-Mail:
Fill in fee simple Title Holder on next page I if different
from the Owner listed above)
E-Malljohniaw5158QaoLcom
State or County License EG 13006370 29432
if value of construction is $2500 or more, a RECORDED Notice of Commencement is requires,
if value of HVAC Is $7,5oo or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER—
Name:
Address:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone
State:
City:
ZIP: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
— Not Applicable
BONDING COMPANY:
Name:
Address:
_Not Applicable
City:
City:
Zip: Phone:
indicated
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and Installation as
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucle County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structure Please consult withpyour Horne Owners owners
andrreview your deed for covenants
ny rrestrictions which maor
applyhlbtt 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. Lucle 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 tender or an attorney before
commencing -work or recorCinS Your NOULe Oi %,unurtcn6crucna.
Signato of own Lessee/Contractor Agent for owner
Signature of ntractor/License Holder
i
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
-7 -TQ) by
The forgoing instrument was acknowledged before me
this -7 day of __J_V I �_ 20Jby
this day of ., . 20_2,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
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REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17