HomeMy WebLinkAboutBuilding Permit Application I
2016-08-10 14:47 AULT BROTHERS INC 7722830321>> P 316
ALL MRZAILE IMO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' Permit Number:
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Building Permit Application
Planning and Development Services
Building)and Code Regulation Division
2300 Vitginia Avenue,Fort Pierce FL 34982 X
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: •Electric
PROPOSED IIVIPF(0VEMENT- L0CA110M-
Address: Lot #1211 1211 Nettles Blvd
Legal Description-. Nettles Island Inc. A Condo-Section-II Parcel 1211 and Pro-Rata share in
Common elements (OR 1622-1040)
PropertyTax ID#: 4502-501-1398-OW -._ _ Lot No. 1211
Site Plan Name: Block No.
Project Name:
Setbacksl t FrontBack: Right side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace existing power pedestal
CONSTRUCTION INFORMATION:
Additional work to tie nertormed under this perms -cIecl all appy:
0H AC Gas Tank Gas Piping _Shutters Windows/Doors
10 Electric 0 Plumbing ❑Sprinklers Generator ❑Roof
F Total Sq.l Ft of Construction: 5 Ft.of First Floor:
Cost Of Construction:$ 11000.00 Utilities:O Sewer 0 Septic Building Height:
OWNERAEWEE: CONTRACTOR:
Name Harold & Joanne Wulff Name: Michael Dale Ault
Address 5986 Adamants Dr. Company:Ault Bros, Inc. Electrical Contractor
City: Colorado Springs State: CO Address:_PO Bax 1528 _
Zip Codi 50924 Fax: City: Port Salerno State. FL
Phone No. Zip Code: 34992 Fax: 772-283-0321
E-Mail: Phone No. 772-283-5520
Fill in fes simple Title Holder on next page(if different ^ E-Mail: aultbtos@yahoo.com
from the Owner listed above) State or County License:EC0001693
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
2016-08-10 14:47 AULT BROTHERS INC 7722830321» P 4/6
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Cr#ON UEN LA►W INFORMATION:
ATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: I __ Name:
Address" - Address:
City: I State: City: State:
Zip: I Phone: _ Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: I Name:
Addressl• Address:
City: City: -
Zip: Phone: Zip: Phone:
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I certify> at 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 id 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.
117
X�A Aff A/Js
Signature of Owner/Lessee/Agent Sig ature o ontractor/ cense er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF M nr _ T� COUNTY OFMc1r�i� —
The forgoing instrument was acknowledged before me The forging instrument was acknowledged before me
this�( -i`day of 20 J 6 by this 0 day of 20 L6-_by
LJ
(Name of person acknowledging) (Name of person acknowledging)
(SignatuFe of Notary Public-State of Florida) (Sig ature of Notary Public-State of Florida)
Personally Known V OR Produced identification _-. Personally Known�_OR Produced Identification .
Type of Iflentification Produced ___.. .. .. .. Type of identification Produced
Commission No. rF 9 `z9g0 a mission No.IFF 90249 b (Seal)
US
,., MICHELLE MARIE MART N
fl yids iCHELLE MARIE MARTIN
C0mmI51Iw N FF 9021100 Notary Public.State of Fla Ida
Revised 07/15/2014 My Caom,Expires Ju129,toil Cummissina#FF 902990
INtlsoudiNstloMlNOl1llYMnl, AVEGETATI
My Comm,Expires Jul 23,2019
REVIEWS FRONT ZONING SUPERVISOR PLANS SA T NGROVE
COUNTER REVIEW REVIEW REVIEW: REVIEW REVIEW REVIEW
DATE
COMPLETE
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INITIALS _.
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