HomeMy WebLinkAbout3828 NIMBLEWILL CT. PSL, FL. 34986 SLC PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: it Ln Permit Number:
Or" LOME
0
' ° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential ._
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: V\ r vn. --
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID Lot No. J -
Site Plan Name:� �a��' - Block No.
Project Name: V ILL -If vt
DETAILED DESCRIPTION OF WORK: Y �`vl
New Electrical Meter JLZ)�L_ 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 Pond
�( Electric Plumbing ,
Sprinklers Generator _ Roof Pitch
, ]
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ I1.3i t'7, _ Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
Name u
Address: IV'na 121� {
City: c� LL►c' 2 State:_
Zip Code �� P- Fax: - g 0 -
Phone No. 7" 35o
E-Mail:-11
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: ?� c
Company:
Address: _
City: State:
Zip Code: Fax:
a-S� I ~mac
Phone No T 79$7 1'�Z� -
E-Mail VV1,
State or county License C #j�l 31J3�
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:
MORTGAGE COMPANY:
ENGI!1IEE . — - Not
Name:_ —
Address: State:.
City: Zip: --
Phone—
fEE SIMPLE TITLE—HOLDER. Not Applicable
Address:
City:
Zip: .. Phone: --
Name:
Address:
City:
Zip: �r_ Phone:
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:
Address: --
City:
Zip: Phone: ---
OWNER/ CONTRACTOR AFFiDVIT: Application is hereby made to obtain a permit to da the work and installation as indicated.
I certify that no wort: or installation has commenced prior to the issuance of a permit.
an a p.licable Home owners Association rules bylaws deep f covenants
any restrictions which maor
applyhEbit such
St. Lucie County makehno representation that is granting a permit evi authorize the Icovpermit holder to build the subject strut ure
which is in conflict ti • �' our }tome owners Asseciatior. and r y perform the work
structure. Please consult with y
In consideration of t:ie grantiif Iansrthe Floridae8u lding Codes and St. Luciree e Coulnity Amin lendments.
in accordance with the approvedp
The folloNing building permit applications ara exempt from undergoing
�dn go ms and afull oeessory uses review:ncurrency pother o additions,
non-residential use
accessory structures, swimming pools, fentes, wai s, g In twice for
WARNING TO OWNER: Your failure to RNoticce of COmmen ement must be ecord a Notice of Commencement recorded in theublic financing, d consult
improvemen':5 to your property
Lucie County a nd posted on the jobsite before the first inspection. If you intend to obtain
with lender or an attorneybefore corr►mencirl work or recordin our Notice of Commencement.
A�
Owne
n�x a of rs Lessee/C
Sigontractor agent for Owner
STATE OF FLORIDAO
COUNTY OF�_ J-�
S%nr to (or affirrrad) and subscribed
fore me Nctazatof
✓. Ph 'cal Presence - � � 2021 by
ion
this day of
�; Cb �.
Name of person making statement.
Personally Known OR Produced identification
Type of Identificaticr
produced 1_7.2— •—..--_-_--.
(Signatu
of ivotary'ublic. State of Florida
Div •.. JULIE JANE MCCAULE Sea
o#apFF�rbliE—State of Fiidrida
Commissi
� tommtssW S HH 49824
Expires oct i, 2024
rousti l irat Na�ary Assn.
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DATE
RECki\,ED
HATE
CoM P I,ETFD
Si inatur of Co actor/license Holder
STATE OF FLORIDA
COUNTY OF
sw n to (or affirmed) and subscribed before me of
Physical Presence or online Notarization
this a day of , 2o2p by
M act. —
Name of person making statement.
Personally Known f OR Produced Identification
Type of identification
Produced
(Signature
Commissi
I
. _ � �JULIE JANE MCCAUL`:Y
Notary Public - State of Floe
iss%n M HH 4982
My Comm. Expires Oct 1, Z024
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