HomeMy WebLinkAboutBuilding Permit ApplicationSl PPLEMENTAL 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.
Signa re of Owner Lessee/Agent Signature ontractor License Holder
STAFFLOR /
O STATE OF FLOR /
COUNTY OF �� U C I COUNTY OFF J , lJC l �P
The forgoing instrument was acknowledged before me
this I day of F t 4 20�i 7by
ajo r,
<h
(Name of person acknowledging)
0
l �X.v�� 6rdmI�) hia'M-
(Signature of Notary Public- State of Florida )
Personally Known _ OR Produced Identification
Type of Identification Produced
Commis -i WAL&"
=''MY COMMISSION # FF984663
,os EXPIRES April 21, 2020
Renis AD,",•'moi 9nI J Fbrwallomm,ry5ervice.0'Pf..,�
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
COMPLETE
INITIALS
The forgoing instrument was acknowledged before me
this ( day of FSS 20 _a by
�m"o /' d" ,, �/ 1,%
(Name of person acknowledging)
on &6k,o Wa//, pva,
(Signature of Notary Public- State of Florida)
Personally Known OR Produced Identification
Type of Identification Produced
commission No, a -e -y--663 (Seal)
a
�"" ANNE BROWN w.
MY COMMISSION # FF9g4�3
(4o7)398.ors3 EXPIRES April 21, 2020
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PLANS VEGETATION SEA TURTLE - MANGROVE
REVIEW REVIEW REVIEW REVIEW
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11
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater 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, wom
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: ! J �V G HI 2I lel,.,
Legal Description:
Property Tax ID#: vj-�� - l> 1 ' C>, - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK:
remove existing pedestal install new PIC 6—
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit — check all apply: I_
HVAC 11 Gas Tank []Gas Piping Shutters a Windows/Doors L
Li Electric Q Plumbing Sprinklers 0 Generator a Roof
Total Sq. Ft of Construction: Sq. Ft. of first Floor:
c/
Cost of Construction: $ %,-2 G `� Utilities: U Sewer r Septic Building Height:
OWNERAESSEE. CONTRACTOR:
Name r ✓, ra to ! F ,�, Name: John R Law
Address- ld U V? v k I i Company: Law's Electrical Service Inc
City: a " : , i—, r f Y State: �f Address. 5158 NW Primm St
Zip Code: ` -/ 0 3 Fax: City_ PT ST Lucie
Phone No. Zip Code: 34983 Fax:
E -Mail: Phone No. 772 370 4357
Fill in fee simple Title Holder on next page (if different E -Mail: johniaw5158@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.
State: FL