HomeMy WebLinkAboutBUILDING PERMIT r
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `rl Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Farm Pierre FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential =o=
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION;.
Address: C� J
Legal Description:
Property Tax ID 4-f S" 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 e nerformed under this permit-1e1_aIJJ apply:
LJHVAC OGasTank E]Gas Piping _Shutters L._.t Windows/Doors
R1Electric Plumbing Sprinklers O Generator Roof
Total Sq.Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ _(rr� CJ_ Utilities: Sewer Il Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name aos i Name: John R Law
Address: 6 Zji6r Company: LaWs Electrical Service Inc
City: s c ,fit State:F Address: 5158 NW Primm St
Zip Code:--- Fax: City: PT ST Lucie State:FL
Phone No. %— - 1 7 — U 3 Zip Cade: 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$ZOO or more,a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LA ]NFORIVIATtQN,
DESIGNER/ENGINEER: —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 Asssociation 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.
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Signature/owner/Lessee/Agent Signature of Cons ctor/License Holder
STATE OF FLOR A - STATE OF FLO )
COUNTY OF�, (JCIP_ COUNTY OF S� ,( ucl
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l day of. A-9 za Lt2jyp this-L�_day of 4 zo 7 by
On f)(? IRL im k)0-/Mg m nnnlo
(Name of person acknowledging) (Name*person acknowledging)
nju Lau
( [d i
(Signature of Notary Public-Slat of Florida) (Signature of Notary Public State of Florida)
Personally Known X, OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission rean Commission No. (Seal)
' ANNE BROWN WALMACH • ,...
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS