HomeMy WebLinkAboutBuilding Permit Application �• WD'.s _ •j rud r
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)462-157$ Commercial Residential xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRE7�USEa IMPROVEMENT":LOCATION.Y ,. .j = >_
Address:
u e
Legal Description:
Property Tax 1D#: "/, - - U ! - G '-I/ –G Zlv -- 7 Lot No.
Site Pian Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
remove existing pedestal install new 150 amp meter combo pack on 2"alum strut stand
AdclCONSTRUCTION fINFORMATlON. ;' � ;
itiona work o #ell orme un er this permit–check a appy:
HVAC LJ Gas Tank Deas Piping _Shutters Windows/Doors
ZElectric D Plumbing Sprinklers 0-Generator Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ &d 00 Utilities:0Sewer Septic Building Height:
OWNERf LESSEE ; CONTRACTOR
Name _ S&�•t'f d- 4 yc t,-e, (3 4 ry Name: John R Law
Address: Ik' a*.r-X– 19 fl– Company: Law's Electrical Service Inc
City: 0 i--r-t-1„i'n State:_aV Address: 5158 NW Primm St
Zip Code: L. 6, JZ 0 Fax: City: PT ST Lucie State:FL
Phone No.— I" Sr :s`.t C� E Zip Code: 34888 Fax:
E-Mail: Phone No. 772 370 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.
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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 Horne Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,l do hereby agree that 1 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.
s
_Signature Owner/Lessee/Agent Signature of Conbtor/License Holder
STATE OF
COUNTY OFOR A STATE OF FLOWDCOUNTY OF tD 44-1)-v7le�
Theforgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this forday of ►4-4•-c-14 20 -L'-)by this 9-- day of al i 4 20 by
1)C-1 RI-6 am (A I oJoag(A
(Name of person acknowledging) (Name erson acknowledging)
AMP /1� ]a 14(1�-//t—
(Signature of Noiari P6blic-tta&of Florida) (Signature of Notary Public-State of Florida)
Personally Known Y, OR Produced Identification Personally Known �—OR Produced Identification
Type of Identification Produced Type of tdentification->Aroduced
Commission 11 Commission No. (Seal)
T W, ANNE BROWN WALMACH •••••.
Revised ? •�4 IXSm,rs .eara0 '?�; M1'COMMISSIOIVW�MACH
�eorj EXA►RES #F 984663
91
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REVIEWS FRONT ZONING SUPERVISOR PLANS. VEGETATION SEA TU "GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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