HomeMy WebLinkAboutBuilding Permit Application 08/04/2015 09:36 7724689745 NIB4IR PAGE 01/03
ALL APPLICABLE INFO MUST BE tOMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit-Number: L5oq 00,3- S
Building Permit Application
Pidnning and Development$ervlces
.Building and Code Regulailon' Division
2306 Virginid Avenue,Fort Pierce FL.3482
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from drop boxclick,arrow at the erid of line
Address: 2 NETTLES BLVD
Legal Description; NETTLES ISLAND SECTION 11 PARCEL 2
Property Tax ID#: 4602-501-0188-000-2 LOT No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left.Side:
LIKE FOR LIKE AIR.60NDITIONING CHANGE OUT
Addit ional worK TO 51-performed unaer tnis permit—check all that apply'.
1zHVAC 0 Gas Tank Flas Piping sh utters Windows/Doors
Electric Q Plumbing 11.sprinklers Generator Roof
Total Sq.Ft of Construction: 5 Pt.of First Floor:
Cost of Construction:$ Utilities: Sewer OSeptic Building Height,
Na Me EDGAR&LAURA JONES Name: PHILIP NISAJR
Address.2 NETTLES BLVD Company:�"R AIR CONDITIOING
City: JENSEN BEACH State:FL Address: 3700 8 US HVVY1
Zip Code.; 24957 Fax: City,. FORT PIERCE State:FL
E-Mail; Phone No. 772-46(3-8115
Fill in fee simple Title Rolder on next page It different E-Mail-,
from the Owner listed above) State or County License: CAC041199
if valve of con4ruction is$Z500 or-more,a RECORDED Notice of commencement is required.
08/04/2015 09:36 7724688745 NZS4IR PAGE 02/03 _
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DESIGNER/ENGINEER: Not Applical Mot Mi c
MORTGAGE COMPANY: Not Appilicable
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 Count makes no representation that Is granting a permit will authorize the permit holder to build the subject structure
which Is in conwict 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�equested 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 co'ncurrency review:room additions,
accessory structures,swimming pools,fences,viiralls,signs,screen rooms and accessOrV uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commenclement may'result in your paying twice for
�'m Drovements to your pro. rty.A Notice of Commencement mustbe recorded and posted on the jobsite
ef'6r8 the first I�spectionl.plefyou Intend to obtain financing,consnwith lend.er or an attorney before
com,meiflcinR=6 or recording_your Notice of Comrnencement.
Signaiur f Owner see/Agent Signat re of Co ac�r/ijcense Holder
STAY OODA
STATE 0 FLORIDA
The forgoing in trwe t was aCk owledged before me The forgoing instrument was acknowledged before me
this day of n A 01' 20 1,5'-by this 1_1 day of AUGUST 20 LV_by
f p son Jckhowled (Name of person acknowledging)
L L 4,re(I
f ers._on1ckhoXwIed
dhature–(R N_
V%W-gtat6 of Florida
Personally Known_OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
S E'OF FLORIDA TATE OF FLORIDA
TAT
PtevisedOWNN K.0"; !�"Fyvirou,10112015 Expires 1012/2015
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