HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: S' a g 1/ 7 Permit Number. / z o - a b
RECEIVE®
0
Building Permit Application JUNG /2 2017
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 x0txxx
PERM IT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PR�POSED`IMPR01/EMENT LOCATION,
Address: f U 7 2, L O C 10VL hik 12, G_T
Legal Description:
Property Tax ID#: LlS— // S'-l� ) - J G G O 1 Lot.No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORKr -
remove exisbng pedestal install new 150 amp meter combo pack on 2"alum strut stand
CONSTRUCTION INFORMATION ;:` ot
itiona wo to a a orme under this perm c- ec a appy:
EIHVAC E]GasTank E:]Gas Piping _Shutters Windows/Doors
ZElectric 0 Plumbing ❑Sprinklers FIGenerator Roof
Total Sq.Ft of Construction: .Ft.of First Floor.
Cost of Construction:$ `C ry
Utilities
Sewer OSeptic Building Height:
OWN ER�LESSEE CONTRACTOR•
Name i,'s i rnki en '7 d c,1� w. Name: John R Law
Address: lo 7 r '. Oc Pity ✓2vL 11 A-0.7 Company: Law's Electrical Service Inc
City:- t- State: r-1 Address: 5158 NW Primm St
tip Code: Fax: City: PT ST Lucie State-FL
Phone No. 9,a e-J C, Zp Code: 34983 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.
StPPLENIfNTA CONSTRUCTt{3N=LIEN LAW INFC3RMATt01
DESIGNERjENGINEER: 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 our Notice of Commencement
/ /� s
_Signature Owner/Lessee/Agent Signature of Con?ctorJLicense Holder
STATE OF FLOR BA� - STATE OF FLO f
COUNTY OF < zt . L JC IP COUNTY OF—m.14
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this AZ>day of M 4 1 20 !!by this Ao9-day of 4q 4 : .20 //by
n n ne M/1 &61jifi 66
(Name f person acknowledging} (Name erson acknowledging)
(Signature of Notary Public Stat o Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification roduced
Commission - --`-sd ICY �j,:�� Commission No. . (Seal)
' ANNE BROWN WALMACH `,;;;�••.
'' EXPIRES April 21,2020 = MY GOlyM! N WAIL
Revised 7 i' ��4 FWWaNmrySemce mm •.,4 COMMISSION�!FF9g4663
to3g SPIRES
No��ygw�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SGROVE
Sal
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS