HomeMy WebLinkAboutBUILDING PERMITf
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 13 Permit Number:
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 xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: / 00;" .11/c /?) J
Legal Description:
Property Tax ID #: .- %Z .-U f J Li CU r Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK.
t' -L, ft'"y �1n„ e, e, r; i i. s`4„ j
CONSTRUCTION INFORMATION:
Additional work to be
rmed under tis permit— check all that appy:
QHVAC LJ Gas Tank ❑Gas Piping DGenerator
Shutters Windows Doors
Z✓ Electric Plumbing Sprinklers Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ fa Utilities: _ Sewer 1:1 Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name et eA,
Address: � q� A/t if/ t✓ 91, ,/
Name: John R Law
Company: Law's Electrical Service Inc
City: `7 c v+l z.h a c gte_t, State: !
Zip Code: 2 4'19 &_ 7 Fax:
Phone No. 9 Cl -
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: 5158 NW Primm St
City: PT ST Lucie State: FL
Zip Code: 34983 Fax:
Phone No. 772 370 4357
E -Mail: johniaw5l58@aol.com
State or County License: 29432
It value of construction is 525UU or more, a RECORDED Notice of Commencement is required.
WINFORMAi [ON
Not
Name:
Address:
City: State:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
— Not Applicable
BONDING COMPANY:
Name:
Name:
Address:
REVIEWS
DATECOUNTER
Address:
City.
SUPERVISOR
REVIEW
City:
Zip: Phone.
SEA TU GROVE
REVIEW REVIEW
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
—Not Applicable
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 vniir Nntirfl of rrt..,..,o.,,....,.._�
_ Signature Owner/ Lessee Agent
STATE OF FLOR A -
COUNTY OF ),C Ito
The forgoing instrument was acknowledged before me
this '�- day of YVq ✓k z- m . 20 Lby
Personally Known k OR Produced Identification
Type of identification Produced
Commission
BROWN WALMACH
Revised d7J'*14 EXPIRES April 21, 2020
s
Signature of Con ctor/License Holder
STATE OF FLO e
COUNTY OF�111-IoO
The forgoing instrument was acknowledged before me
this 2- day of 20 1 'f by
40
(Name gfperson acknowledging) I
(Signature of Notary Public- State of Florida j
Personally Known ORProduced Identification
Type of Identification rode ced
Commission No.r 1 j. . (Seal)
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REVIEWS
DATECOUNTER
FRONT
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TU GROVE
REVIEW REVIEW
COMPLETE
INITIALS