HomeMy WebLinkAboutBuilding Permit Application (3) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 6/2/15 Permit Number.
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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 xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 588 NETTLES BLVD
Legal Description: NETTLES ISLAND INC,A CONDO-SECTION It PARCEL 588 ANDPRO-RATA SHARE IN COMMON ELEMENTS(OR 3371-1414:3371-1418)
Property Tax ID#: 4502-501-0774-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
remove pedestal install 150 amp meter combo pack mounted on alum strut stand
CONSTRUCTION INFORMATION:
it
ional work to bfeertormed unde t Is permit—check all appy:
HVAC Gas Tank F]Gas Piping Shutters ❑Windows/Doors
✓❑_Electric ❑ Plumbing Sprinklers Generator ❑ Roof
Total Sq. Ft of Construction: SFt. of First Floor:
�•r
Cost of Construction:$ /, 5 G �J Utilities: Sewer Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Lorraine Brodsky(LF EST)Edward W Brodsky Terry B Lucash Name: John r law
Address:588 Nettles Blvd Company: laws electrical service inc
City: Jensen Beach, State:FL Address: 5158 nw primm st
Zip Code: 34957 Fax: City: pt st lucie State:fl
Phone No.229 2239 Zip Code: 34983 Fax:
E-Mail: Phone No. 370 4357
Fill in fee simple Title Holder on next page(if different E-Mail: I.ohnlaw5158@aol.com
from the Owner listed above) State or County License: 25284
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 your Notice of Commencement.
Sign Are of Owner/Lessee/Agent SignatureZf Contraftor/License Holder
STA OF FLORIDA STATE OF FLOR A
COUNTY OFCOUNTY OF
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The forgoing instru nt was acknowledged Wore me The forgoing instru ent was acknowledged before me
%`qday 15 by
this-4eviday of 20 LS_by this 21 of 20
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(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida (Sign/atdre of Notary Public-State of Florida
Personally KnownoR Produced Identification Personally Known OR Produced Identification
Type of Identificat4ionroduced Type of Identification Produced
Commission No.Roiii 53 KtVWYN BLIMSERA Commission NoFF 0�31 3 (Seal)
NOTARY PILISM KATHRYN BLIKIIIIWERA
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DATE
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INITIALS