HomeMy WebLinkAbout605 nettles permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02 L11 a Permit Number:
goOMENSWAMEMEM
w�- 'J:
t Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxMXxxxx
PERMIT TYPE:
LOCATION:
Address:
Property Tax ID #: I SO 3- $'O / 0 7 1 - G a a' fl� Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply.-
Block No.
-Mechanical
_Gas Tank
_Gas Piping
_Shutters
—Windows/Doors
✓Electric
_ Plumbing
—Sprinklers
_ Generator
—Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ a ClO eJ v
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name "To S e G
Name:dohn Law
Company: Lav1s Electrical Service Inc.
Address:5158 NW Primm St
Address: G /i c" /Vo h`/r1 Rl /
City: c t#, ,(Sr ea-cl, State: F/
Zip Code: 3Y c18'7 Fax:
City: Pt St Lucie State: F1
Phone No. /- 9,f6' °Z Y 6 - '710 7
Zip Code: 34983 Fax:
E-Mail:
Phone No 772 370 4357
Fill in fee simple Title Holder on next page ( if different
E-Mailjohniaw5158@aol.com
State or County License EC 13006370 29432
from the Owner listed above)
If value of construction is $2S00 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER NGINEER: _Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
city:
City:
Zip: Phone:
__,. --� ,..,weliatinn �c indiratPd.
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to ootam a perma Luau a,a ..0 -„ -------------
I certify that no work or installation has commenced prior to the issuance of a permit.
St Lpcie Coup makes no repre{ent tion that is granting a vermit lii authorize the permit holder to build the subject s1�ruMure
which Is m eon le! wi h an pplicab�e Home Owners Association rues, bylaws ar and covenants that may restrict or pro Iblt such
structure. Please consult wit your Home Owners Association and review your deed for any restrictions which may apply.
inconsideration 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. Lurie 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 an the jobsite
before the first Inspection. If you intend to obtain financing, consult with lender or an attorney before
STATE OF FLORIDA
COUNTY Of
The forgoing instrument was acknowledged before me
this _Lday of F-r (y 20_22bY
Name of person Tpl dng statement
Personally Known ,ems OR Produced Identification
Type of Identification
Produced
ram.}::{ f
(Slgnaturd of Notary Public- State +
Commission No. V s-
REVIEWS
Rev. 812/17
FRONT I ZONING
COUNTER REVIEW
STATE Of FLORIDA
COUNTY Of
The for oIng instru��ty+as acknowledged before me
this T day of ti*. 20,0pby
Name of person making statement
personally Known / OR Produced Identification
Type of Identification
Produced
RACHEL Ilia DAVIS I _
MY COMMISSIONl Jpp No.
EXPIRES Jana ry 5. 2019
SUPERVISOR PLANS VEGETATION
REVIEW REVIEW I REVIEW
RACHEL M
MY COMMISSION