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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and We Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34981 Phone: (772) 462-1553 Fax: (772) 462--2578 Commercial Residential x PERMIT APPLICATION FOR-- To Select from dropbox, click arrow at the end of line PROPOSED. -IMPROVEiU1ENT LQCATION _ =:: = Address: Legal Description: Property Tax ID.#, off- 01r 0f"/6' �- 0&C Lot -No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION -OF WORK - remove existing pedestal install new CONSTRUCTION INFORMATION: Additiona-F—Worl(SEh 8artormpil un PY 1G normirt — r ar a + .., ,.. Block No. HVAC HVAC Electric Gas Tank Plumbing "-- Gas Piping []Sprinklers OShutters Q Windows/Doors Generator Roof Total Sq. Ft of Construction: Cost of Construction: $ S-0 "J Ft. of First Floor: Utilities• Sewer 0 Septic OWNER/LESSEEL• Name 65 k'u _ Address: 1 -) ice_ city: State: Zip Code: _3 `I _ !2 u Phone No. L It U E -Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Name: John R Law Building Height: Company: ms's Elecbical Service Inc Address: 5158 NW Primm St Cly: PT ST Lucie State: FL Zip Code: 34983 - Fax* Phone No. 772 370 4357 E -Mail: iohnlaw5158@aol.00m State or County License: 29432 If value of Construction is $2500 or more, a RECORDED Notice of Commencement Is required. SUPPLEMENTAL -CONS_ TRUMON LIENLA1111:11�t��RN1AT10W-------------- DESIGNER/ENGINEER:a Name:� Not Applicable MORTGAGE COMPANY Pp Not Applicable Name: '- Address: Name: Address: City: State: Zip: Phone: City: State: Zip: _ Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY - Name: _ Not Applicable Address: Name: City: Address: Zip: Phone: City: - Zip: --. Phone_ I certify that no work or installation has commenced prior to the issuance of a permit. 5t. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and 5t. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Cornmencernent may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attomey before commencing work or recording our Notice of CornrnPnrrprna.,+ 1 Signature/ Owner/ Lessee/Agent STATE OF FLOR SA COUNTY OF [ The forgoing instrument was acknowledged before me this -LT day of .$—.: 20 L2_bv Personally Known K OR Produced Identifcation Type of Identification Produced Commission ANNE BROWN WALMACH Reprised 1170; L4 EXPIRES April 21. 2020 Signature of Con ctor/Licens�Holde�r� 5 STATE OF FLO c COUNTY OF� f F The forgoing instrument was acknowledged before me this 41 day of 4 ,- 20 1�2_ by (Name erson acknowledging) r � i (Signature of Notary Public -State of Florida) Personally KnownOR Produced IdentificationTYpe of fdentificatian roduced Commission No. �(seal) RlVfl=V11S ICO ONTER REVIEWING I s REVIEW©RI PLANS REVIEW INITIAL5 h YC aMlurss am W ALMgCH - f+RES 1663 VEGETATION SEA TU NGRO REVIEW REVIEW REVIEW