HomeMy WebLinkAboutBUILDING PERMIT APPLICATION'ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /] I _ y�/� r 1
Date:01/07/19 Permit Number: ilotd-099 7
SCANNED
BY
Building Permit Application St. LucieCountV
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 X
PERMIT APPLICATION FOR: Other-
�, PROPOSED IMPROVEMENT LOCATION:
Address: 1108 NETTLES BLVD, JENSEN BEACH, FL 34957
Legal Description: RESIDENTIAL HOME
Property Tax ID #: 4502-501-1295-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION 'OF WORK: = III
-zc *;k
INSTALL 32" HIGH
11HVAC U—GasTank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1550
WITH STAIRS IN BACK OF HOUSE
Piping I (Shutters
nklers Generator
_ S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Windows/Doors
0 Roof = Roof pitch
Building Height:
CO. JAG7OR
Name L/1RGHI PROP(=f t*,MANAGEMENT LLC
Name?`(" YW O
Address: 1'766 SW CAPTAIN PLACE
Company . H)GHTOVIIER CONSTRUCTION INC
City PALM CITY, '::` ,, State: FL
Zip Codei'34990 FFax: U
Phone No. 954-465-3242
Add res§l 1750 SE N'BUTT,ONWOOD DR
City: PSL State: FL
Zip Code: 34952 Fax:
Phone No. 772-626-8722
E-Mail: LARGHIPM@GMAIL.COM
Fill in fee simple Title Holder on next page ('if different
from the Owner listed above)
E-Mail: NHTOWER@AOL.COM
State or County License: CGC-151-3256
II If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. �I
jar
N
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Address: 1750 SE N BUTTONWOOD DR Address:
City: City:_
Zip: Phone: Zip:
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 permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws 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 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 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.
S' tur owneinessee ontractor as Agent for Owner
'Signature of Contractor/Licen'se Holder•!
`STATE OF FLORIDA
STATE OF FLORIDO
COUNTY OFE, I't„i
COUNTY OF ,3 .l x c�
The foriging instr e t was acknowledged before me
The fo going instrument was acknowledged before me
this r�—day of 20a by
thisday o 20j`_ by
U/D_
Y9F�Ln— Q o sn)
Name of perso a ng statement
I Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Ide 'fication
Type of (dent ca ion
Produced i e
Produced 1..-
� �ofh14
(Signs re Notary Public -State of Florida�ene Edlund-Chen
(Signature of Notary Pub -State of Florid )
Commis ion No. R TARYPUBLIC
VF aro'�•.,,-
Commission No. LASHAH-RAHMING
STATE OF FLORIDA
My COMMISSION# GG 275M
Comm# GG011599
�'^'•yam a' EXPIRES: Decembel20, 2022
e:
iH GiOPF
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17