HomeMy WebLinkAbout579 nettles permit All APPLICABL INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l vZ1 Permit Number:
'J -
1"0.s ;
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 xmw=
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: E 7 2 A),- Hlr-'
(
Property Tax ID#: -7 EO A - .5-U f — Q 7 6 0 !JG - ( Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION,INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing —Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ V U Utilities: —Sewer _Septic Building Height:
OWNERAESSEE CONTRACTOR:
Name Mlt, f•I7 osa-on Name-John Law
Address: `S 7 9 Ale /fl e K?b-Z company:Law's Electrical Service Inc.
City: State: Address:5158 NW Primm St
Zip Code: 3 cY 79 7 Fax: City: Pt St Lucie State:FI
Phone No. 77 A A 4'1- SAD Zip Code: 34983 Fax:
E-Mail: Phone No 772 370 4357
Fill in fee simple Title Holder on next page(if different E-Mailjohnlaw5158@aol.com
from the Owner listed above) State or County License EC 13006370 29432
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORAr1ATI+ON:
DESIGNER/ENGINEER- _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
G£Y: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: Cite:
Zip: Phone: f Zip; Phone:
OWNER/CONTRACTOR AFFIOVIT: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 lLeupie County makes no representation that is granting a Dermit will authorize the permit holder to build the subject ss�trr��icture
which Is in conflict with any applicable Home Owners Association rules,by 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 app(Ications 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 lender or an attorney before
commencing.work or recording our Notice of Commencement.
Signat!0 of Owner/Lessee/Contractor as Agent for Owner Signature a# ntractar/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this At day of 3"_ ' 4I., 2rJ�-by this R r day of O'� — 20&2by
Name of person making statement Name of person making statement
Personally Known G'OR Produced Identification Personally Known�OR Produced identification
Type of identification Type of identification
Produced Produced
(Signature of Notary Public State o bf Notary Public State of Florida)
FtACHEL
..
• Commission No.'s 4 _ # a i My DAVISCOMMISSIOPlrRiirl No.
lt EfPIFiES Janu 5,2at& ' kd!at FIACHEL M DA I
{apr)7@8+YI53 FloriCaNatarySereice.ca!n
'1 My COMMISSION#Fri t
., ,�,.• EXI'IFIES January 5, 2 9
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION li&.
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW R
DATE
RECEIVED
DATE
COMPLETED
Rev.S/2/17