HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '� �T ��' Permit Number: (gy, O\(OI
Building Permit Application APR 2 2 2016
Planning and Development Services
Building andlCode Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 27 NETTLES BLVD
Legal Description: NETTLES ISLAND INC,A CONDO-SECTION II PARCEL 27 AND PRO-RATA SHARE IN COMMON ELEMENTS(OR 3496-1277)
Property Tax ID#: 4502-501-0213-000-7 Lot No.
Site Plan Name-eBlock No.
Project Name:
I
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF;WORK.,
remove existing pedestal install new travel trailer pack on 2" strut stand
777.
CO.NSTRUCTION:INFORMATIO,N. ,
itlona Workto e e orme under this permit—check a appy:
HVAC 0 Gas Tank ❑Gas Piping Shutters Q Windows/Doors
aElectric 1:1 Plumbing Sprinklers OGenerator Roof
Total Sq.Ftlof Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 1,200.0.0 Utilities:0 Sewer O Septie Building Height-
OWNER/LESSEE: ` CONTRACTOR:
Name Richard H Hartmann Name: John R Law
Address:P,O Box 717 Company: Law's Electrical Service Inc
City: Cutchogue State:NY Address: 5158 NW Primm St
Zip Code: 111935 Fax: City: Pt St Lucie State:FL
Phone No.11 631 987 8199 Zip Code: 34983 Fax:
E-Mail: I Phone No. 370 4357
Fill in fee simple Title Holder on next page(if different E-Mail: johnlaw5158@aol.com
from the Owner listed above) State or County License: 29432
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
I
I
SU,P.PLEMENTAL,CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: I Name:
Address: I Address:
City: State: City: State,
Zip: I Phone: Zip: Phone:
I
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: I City:
Zip: Phone: Zip: Phone:
I
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 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 accordanceiwith 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 strulctures,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
_
Signa)9e of Owner//Lessee/Agent Signa a of Contractor/License Holder
STATE OF FLORIDA ST TE OF FLORID
COUNTY OF COUNTY OF
The forgoinglinstr ent was acknowledged before me The forgoing instrument was acknowledged before me
this�day of Jut 20 Lbby this day of 20/6 by
a e of person acknowledging) t
e of person acknowledging)
��J W4" 9
(Signature of otary. Public-State of Flo da) (Signature of Not Public-State of Flori )
Personally Known v OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 17/15/2014
I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
I