HomeMy WebLinkAboutBuilding Permit Application 07/06/2015 2:38 PM FAX 7723372699 KENT BLOSSER IM 0002/0003
ALL APPLICABLE MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f
Date; —170 Permit Number:JS V�
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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 x
PERMIT APPLICATION FOR: Electrical
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Address: 1138 Nettles, Jensen BEach, FI 34957
Legal Description: Nettles Island Inc.A condo-Section II parcel 1138
Property Tax ID#: 4502-501-1325-000-2 Lot No.
Site Plan Name: 1138 Nettles Block No.
Project Name; Lloyd Residence
Setbacks Front Back: Right Side: Left Side:
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Replace service pedestal.
Replace GFI at front door.
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Additional worko e er orme under this perm –c ec a appy:
HVAC Gas Tank 0Gas Piping _Shutters ❑Windows/Doors
EJElectric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction: $ 1200,00 .._ Utilities: Sower OSeptic Building Height:
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Name Medredith Lloyd Name: Kent Blosser
Address;19 Wilkin Ave Company: Blosser Electric
City: Middletown State; NY Address: PO Box 7305
Zip Code: 10940 Fax:_ city: Port St Lucie State:FI
Phone No.845-343-8030 zip Codc° 34985 Fax.• 772-337-2699
E-Mail:mlloyd1@frontiernet,net Phone No 772-337-0055
Fill in fee simple Title Holder on next page( if different E-Mail: nrblosser@gmail.com
from the Owner listed above) State or County License: EC13001570
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
07/06/2015 2:38 PR FAX 7723372699 KENT–BLOSSER 20003/0003
VA
DESIGNER/ENGINEER: Not Applicably MORTGAGE COMPANY; Not Applicable
Name: Name:
Address; Address,
City.- 'State: City: State:
Zip: Phone- Zip: ' Phone.,
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of 8 permit,
St,Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply,
in consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments,
The following building permit applications are exempt from undergoing a full concurrency review:room addition$,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO 0 ER:Your failure to Record a Notice of Commencement may rosult'n your paying twice for
improvements yo r property. A Notice of Commencement must be recorded a d posted on the jobsite
the
Ins ,
before the fJ t Ins ction. If you intend to obtain financing, consult wit i lender En atto y before
l, w.r or
co-mmi�n g wo or recording,-WZr Notice of Commencement.-
Ltignature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA I
COUNTY OF :5r COUNTY OF a Jcy&AJL
The forgoing instrument was acknowledged before me The forgoing in5trumynt was acknowledged before me
this 2jaClay of --ILL- 2 0 1.6_7' by thisaqn04tday of .—.20 by
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(N j of person acik—nowle in I (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) '(Signature of Notary Public-State of Florida)
Personally Known_OR Produced Identification Personally Known_OR Produced Identification
type of Identification Pro pe of Identification Produced
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SAVITRI V.GAI:IAICIA
.101 1 M,GAR IA
Commission No. -6N0vpqubllc-State of Florida ommisgion No. t Florida
• Apr
1.21)16[ N(cluly FU C-SIM(!0 161
185 1 my Comm.Expires Apr 1 2016
My Comm.EXpires Apr 1.2016
t nom.
Commission#FE 185 187
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DA'rE
COMPLETE
INITIALS L