HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPI-ICATION TO BE ACCEPTED
Date_ Permit Number:
S - J
Building Permit Application
Planning and Development5ervices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)4621578 Commercial Residential m000m
PERMIT APPLICATION FOR* To Select from dropbox, dick arrow at the end of line
PROPOSED IMPROVEMENT LaCATI(}N _
Address:_ IV yz. G3
Legal Description: —
Property Tax ID R.- - t�S GIB (... {j�� ' � Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right5ide Left Side:
DETAILED DESCRIPTION'OF[ :WO. K.
remove existing pedestal install new
CONSTRUCTION INFORMATIDN.
nnAdditional work o bTG
is permtt-c ec a aP13 Y'
L1 HvAC Tankme un er Gas Piping _Shutters Windows/Doors
21 Electric 1:1 Plumbing R5prinklers I�I Generator C]Roof
Total Sq.Ft of Construction: S Ft,of First Floor,
Cost of Construction:$ Utilities
Cost Building Height:
OWNER/LESSEE: : CQNTRACTIR.
IVanler_v c-� art '? f Name- John R Law
Address_ S C`.� r i l .� Ill, Company: LaWs Electrical Service Inc
City: a Stater( Address: 5158 NW Primm St
Zip Code: .3 7 It -7 3 Fax: City: PT ST I_uae State:F1_
Phone No. - I I L 7 u ' Zip Code: 34983 Fax:
E-Mail: Phone No. 772 370 4357
Fill in fee simple Title Holder on next page(if different E-Mail-johnlaw5i58@aol.com
from the Owner listed above) State or County License: 29432
If value of construction is U500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW.1NFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY- Not Applicable
Name: Ni,
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 Horne 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 1 will,in all respects,perform the work
in accordance with the approved plans,the Florida Bullding Codes and St.Lucie County Amendments.
The fallowing bundling 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.
Signature Owner/Lessee/Agent Signature of Cant ctor/I<icense Holder
STATE OF FLOR A STATE OF FLO t
COUNTY OF r1-061,10 - COUNTY OF I'1 f
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Iff day of Ato ZQ why this 17'-( day of 4,r 20 _LL by
U", W C'
6h—
(Narne of person acknowledging) (Warne erson acknowledging)
n'd
- - _� 1�2 A(
ila
(Signature of Notary Public-Stath of 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 produced
Commission ` Commission No. � (Seal)
PliVNE BROWN 3WA1_MACii .g;R;'
RevisedQ�fflr-j4I:x l�zr<s April 21,Bozo , '' MY� WA
oAfMISSlbly �� � �
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SFA GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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