HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ! 1 j ? Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 452-1578 Commercial Residential =o=
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: U 72
Legal Description:
Property Tax ID #_ 1V S J r SG - 4a — �a `� — Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
remove existing pedestal install new 150 amp meter combo pack on 2" alum strut stand
CONSTRUCTION INFORMATION:
Additional wOrktaht-hpFfErmpritm pr t tc rwrm�t _
11HVAC Gas Tank ❑Gas Piping
Electric ElPlumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 4, & u '
OWNERAESSEE:
that appy:
1:1_ Shutters
IGenerator
S Ft. of First Floor: _
Utilities:T]Sewer 01 Septic
Name -,e h LFVi lA 4d c v4 ,
Address:7 S`__.S- 0 [ r 4�,
17�4 tt Se, c� _
City: { ,.'s { State: rL
Zip Code:_ 3 `y �i,� 7 Fax:
Phone No, 22, 1 A 12, -
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
John R Law
Windows/ boors
® Roof
Building Height:
Company: Law's Electrical Service Inc
Address: 5158 NW F'rimm St
City: PT ST Lucie
Zip Code: 34983 Fax:
Phone No. 772 370 4357
E -Mail: johnlaw5158@aol.com
State or County License: 29432
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FL
SUPPLEMENTAL CONSTRUCTION LIEN L41111 INFpRMp,Tt4111
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
ZONING
Name: ^`
Address:
City:
Address:
State:
Zip: Phone:
ate:
Zip:
REVIEW
- Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Address_
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 our Notice of Commencement
_Signa re of Owner/ Lessee/Agent
SJTAE OF FLOR
COUNTYOF l P
The forgoing instrument was acknowledged before me
this _LL day of 2011by
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Com
My COMMISSION # FF9U663
EXPIRES April 21, 2020
Signature ontractor/License Holder s
STATE OF FLOR
COUNTY OF '
The forgoing instrument was acknowledged before me
this 11clayof —_' _ 20 _L2 by
c .
(Name of person acknowledging)
�v��7 G�
(Signature of Notary Public- State of Florida ?
Personally Known OR Produced Identification
Type of Identification Produced
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
COUNTER
REVIEW
REVIEW
REVIEW
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COMPLETE
INITIALS
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ANNE BRnun, .---
COMMISSION # FF.*•,,4ri
EXPIRES 984663
aPn121, 2020
FLua.—.. _
VEGETATION l SEA TURTLE TMANGROVE
REVIEW REVIEW REVIEW