HomeMy WebLinkAboutBuilding Permit Application i
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: f �' 0," ow
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 j
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED-IMPROVEMENT LOCATION:
Address: 12450 Williams Road
Legal Description:
f Property Tax ID#: 3308-421-0000-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Rebuild Agriculture pump service
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CONSTRUCTION INFORMATION:
itiona war to e e orme under tispermit—c ec a appy:
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DHVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
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Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 1000.00 Utilities:Sewer Septic Building Height:
OWN ER/LESSEE: CONTRACTOR
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Name Bailey Williams Road LLC Name: Lawrence Stubbs
Address:849 20th Street ,y• tL6mpany: S&W Electric Inc
City: Vero BeachC
State:FI " s st, ok_er Road
501;1Ne
"Zip Code: 32960 Fax. ;Ci 1fPieree"'� :I State FL
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Phone No. Tip de:i, :ai>FeZcI,, 4-4273
`.E-Mail: ne;No. 464A466,-
Fill in fee simple Title Holderon°next page(if different E-Mail: stuboutelectric@
from the Owner listed above) State or County License: 29442
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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 th Irst inspection. If you intend to obtain financing,consult with lender or an attorney before
commenorng work or recordin our Notice of Commencement.
S
ignature of Owner/Lessee/Contractor as Agent for Owner at a r icense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The fojoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thi . -1 day of 20 -Qby this�`�day of 20 by
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(N a of erson acknowledging) (Name of person acknowledging)
igna re of Notary Public-St to of Florida) (Sigagurd of Notary Public-Stat f Florida)
Personally Known OR Produce Identif}�at�io�nPersonally Known OR Produced Identification
Type of Identification ProducedL- Type of Identification Produced >
Commission No. (Seal) mission No. (Seal)
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DATE
COMPLETE
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