HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO!'MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: oC' 1 1 I o �ol
Permit Number:
RECEIVED
Building Permit Application Planning and.Development Services FEB 2 q 1 2017
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 PERMITTINGnty,
, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Reside
t9l �ie Coulinty
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 136 Commonwealth Ct 34949
Legal Description:
Property Tax ID#: / L/ / t/ 7 /— v l ? / — o U U — 1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
wiring of boat lift
CONSTRUCTION INFORMATION:
Additional work toe e orme under t —checkispermit a appy:
QHVAC Ei Gas Tank Q Piping in Gas Pi Shutters Windows/Doors
— Q
Electric ❑Plumbing Sprinklers Q Generator Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ �— Utilities. Sewer ElSeptic Building Height:
r
OWNER/LESSEE: CONTRACTOR:
Name rYX C, L Z ,^� Name: Lawrence Stubbs
Address: / 6 C o.-- �... ,�r / 7� Gr— Company: S&W Electric Inc
City: f P,'t State:rL , Address: 501 w.Coker-Rd
Zip Code: Fax: City: Ft.Pierce State:FL
Phone No. Zip Code: 34945' Fax: 464-4273
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: 464-6466
from the Owner listed above) State or County License: 29442
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL 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 TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: 7 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 ith lender or an attorney before
commencinamvork or recording ou Notice of Commencement.
s
ignature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDAC I ,
COUNTY OF �)(�II i COUNTY OF �1�1�
The forgoing instrument was acknowledged before me The forgoing instrume t was acknowledged before me
this day of 20) by thisS�L day of20` t_by
L�Nw f tpwrr I\C2�0"o ZA e,6
(Name of person acknowledging) (Name of person acknowledging
2,c, CJ_
(Signature of Notary Public-State of Florida) (Signature of tary Public-State of Florida)
Personally Known ORProduce Identification " Personally Known OR Prod Ide tification
Type of Identification Produced .� Type of Identification Produced ��,
Commission No. KAREN S. NI r1R,p1ssi No�
``�M1,pY PUs((Iii
_= Commission;* F1 115637 KAREN S. NIELSEN
Gommissien N FFA 15637
My I
Revised 07/15/2014 6' June 12, 201 8 - a,F My Commission Expires
"'"�,, June 12, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS