HomeMy WebLinkAbout384 nettlesAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: %4zxI Permit Number:
Building Permit 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 xxxxxxxx
PERMIT TYPE:
I PROPOSED IMPROVEMENT LOCATION:
8 I
Address: 3c1 /y y �*✓ %�4� /
Property Tax ID fi: 5-o l — G S %d — 006' 2 Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
Block No.
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
_Mechanical
Ylectric
_ Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ or, a G
_ Gas Piping
_ Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
-Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name ine4.9-l0 L G
Name: John Law
Company:Law's Electrical Service Inc.
Address:-M) Or e 'd/ c 4✓r
City: Mm S State: _E�/
Zip Code: Fax:
Phone No. / - 3oS- 3 3 S-- R 3 5-6
E-Mail:
Address:5158 NW Primm St
City: Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailjohnlaw5158®aol.com
State or County License EC 13006370 29432
If value of construction is $2500 or more, a RECORDED Notice of Gommencemenr is requirea.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
State:
City:
State:
City:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address-
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permn Lo au Lne wor R a„. �• -- •••-•-----
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countfly makes noVreprese tation that is granting a permit will authorize the permit holder to build the subject structure
strructure, Please consult wlthpyoiurN ome Own rs Associationtiandrreview your deed or any restrictionnts that s which restrict or
applyhibYt 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 fender or an attorney before
commencn orK or reCorcing your IMULILIC UI \ UIIIIIIQI
min
Signature of ontractor/License Holder
I
signatgA of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
2G,&J by
The forgoing Instrument was acknowledged before me
this-7 day of _Jry 1 20_a/by
this _Z day of J,1�
Name of person making statement
Personally Known f OR Produced Identification
Name of person m king statement
aOR
Personally Known �✓ Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Fe
bf Notary Public -state of Florida)
(signature of Notary Public- State ol
-. RACHEL
DAMS
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No ` ' �
Commission No. fir- € ` - %''• 1 My cOMMisslo
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EXPIRES Janui
try 5, 2013
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''x.„a� � t S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION 811116
REVIEW REVIEW REVIE
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17