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HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Dumber: 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: z Z& Legal Description: Property Tax ID Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: remove existing pedestal install new CONSTRUCTION INFORMATION: Additional work to epertormed unclerthispermit—c eck all that apply: OHVAC '` Gas Tank ®Gas Piping Shutters a Windows/Doors ZElectric Plumbing Sprinklers 0 Generator O—Roof Total Sq.Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ 1kc,10 Utilities:0 Sewer 0 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name rr Wl "Yrvi Name: John R Law Address: .�r,q 7 c t c„ Company: Law's Electrical Service Inc City: yc u'- _ State: Address: 5158 NW F'rimm St Zip Code: ! Fax: City: PT ST Lucie State:FL Phone No. 0 S-- Z S—L(_ 3 k, 7 Zip Code: 34983 Fax: E-Mail: Phone No. 772 370 4357 Fill in fee simple Title Holder on next page(if different E-Mail: johnlaw5l58@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. SUPPLEM NTALCONSTRUCTION LIEN LAW INFORMATION ©ESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City`- _ -- State: City. State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONING 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 pen-nit. 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 your Notice of Commencement. s _Signature Ownerf Lessee/Agent Signature of Con ctor/License Holder STATE OF FLOR A - STATE OF FL©E� COUNTY OF j � 1 COUNTY OF } f� , �{ The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this ( day of 14 i ZO lay this If, day of. s l �, 20 by �n ne BrL6 wa 1410- Al--naa (AJ0—Jk2a L� (Name f person acknowledging) (Name erson acknowledging) J. nJJI + / - (Signature of Notary Public-Scat 'o Florida) (Signature of rotary Public-State of Florida) Personally Known K OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification roduced n CommissionWEI Commission No. Ak? (Seal) ; x .Y ANN€BROWN WALMACli ,i• s'".'. Revised 4II<s Ilpti124,202E1 MY contn�rs N W' LMACy 7 F,� N�,,,sn;�, sroly Fa3 713 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA7i GROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW BATE COMPLETE MITIALS —J