HomeMy WebLinkAbout1363 nettles permit.pdfAll APPLICABLE N O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 It 2 Permit Number:
w Building Permit Application
Planning ana ueveaopmenr�ervices
Suiiding and Code Reguiation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential )000000IX
PERMIT TYPE:
F—PRoPOSED IMPROVEMENT LOCATION:
Address: to C-M Ca '-W ��
Property Tax ID #: 41 a .i'-0 / — ./S'--s'70 ' 2 C/ 0
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas Piping _Shutters
_ E ectric — Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: T Sq. Ft. of First Floor: _
Cost of Construction: $ 01 j C/o c Utilities: _ Sewer _ Septic
Lot No.
Windows/Doors
_ Roof Pitch
Building Height:
OWNERAESSEE•
required
CONTRACTOR:
~Name YI..._ _ i A W9:n Wd X //
Name:Jul'II L=w
—� ,*"
LaVs Electrical service Inc.
Address: inG bA'rn�T S�
Company:
Address:5158 NW Primm St
/ State: /'YlR
City: {� y%c� ro
Zip Code: OA 70 3 Fax:
City: Pt St Lucie State: FI
^ho-r ^!c I" SO&- 3 �l j — I Y(o D
71p Cnde, 34983 Fax:
Phone No 772 370 4357
E-Mail:
E-Maillohniaw5158@aoLcom
Fill in fee simple Title Holder on next page ( if dtfferent
State or County License EC 13006370 29432
from the Owner 1#sled above)
t I
s
IB Y914c 1a1 aw Msu .., Y�wvv v �,� - "
if value of HVAC is $7,500 or more, 8 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:
Zip: Phone
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zlp: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I 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 Dermit ill authorize the permit holder to build the subject structure
which is 1n conflict with any applicable Home Owners Association rues, bylaws or and covenants that may restrict or prohibit such
for which may apply.
structure. Please consult with your Home Owners Association and review your deed any restrictions
in consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
Building Codes and St. Lucie County Amendments.
in accordance with the approved plans, the Florida
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
to another non-residential use
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
be recorded and posted on the jobsite
improvements to your property. A Notice of Commencement must
if intend to obtain financing, consult with lender or an attorney before
before the first inspection. you
commencingy4ork or recording our Notice of Commencement.
Signat of Owner/ Lessee/Contractor as Agent for Owner Signature of ontractorJucense Haller
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fort' ling instrument was acknowledged before me The forging instrument was acknowledged before me
day of ac 2o9y
this 1_ day of Qc- { 2Q-11 by this
Name of person milking statement Name of person making statement
Personally Known OR Produced identification
Personally Known -__:,Z' OR Produced Identification —"Z
Type of Identification
Type of Identification
Produced
Produced
I f
f Notary Publ c State of Florida)
(Signature of Notary Public State o
RACHEL DAMS
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No
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EXPIRES Janu January 5, 2049 f €. ;• my COMMtS510N #FFt T
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9
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION "
REVIEW REVIEW REVIEW REVI
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COM LETED
Rev.8/2/17