HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLE I M FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
{_ J. RECEI D SEP 19 2017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Yrginio Avenue,fort Pierce FL 34952
Phone:(772).462-1553 Fax:(772)462-1578 Commercial Residential L,—"�
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end-of Fine
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description-
ProperlyTax iD# lL�1r t�- U. C�— j�Dl -- Lot No.
Site Plan Name: Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONST�00-bey
N INFORMATION:
ttrone orme un er is permit ee a app y:
1.HVAC L`_{Gas Tank ❑Gas Piping _Shutters F]Windows/Doors
U Electric Q Plumbing Sprinklers 1:1 Generator FiRoof Roof pitch
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 6426, 00 Utilities Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name l Name: dames W Law - --
Address: Company: Law's Efectric,Inc.
,. State: Address. 218 Beach Avenue
Zip Code:c&gP�/`/ Fax: City, Port St.Lucie State: FL
Phone No.
Zip Code: 34952 Faac 772-878-3347
E-Mail: Phone No. 772-971-451.2
Fitt in fee simple Title Holster on next page(If different. E-Mail: lawselectricinc(gaol_cbm
from the owner listed above) State or County License: ER0000122
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: ,J Not Applicable MORTGAGE COMPANY: A/Nbt Applicable
Name: Name-
Address- Address:
Cty: State: City: state:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _k/_Not Applicable BONDING COMPANY: Not Applicable
Name- Name:
Address' Address:
City: t aty:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced.priorto the Issuance of a permit.
St.Lucie CountLyy makes no representation that is granting a permit will authorize theermit 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 revlewr your deed for any restrictions which may apply.
In consideration of the granting of this requested permit i do hereby agree that]will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and Sit.Lucie County Amendments.
Thefoilowing building permit applications are exempt from.undergoinga 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
commencingwork or recording our Notice of Commencement.
gipiftureof Owner/Agent/Lessee ature of Contractor/1-kense Holder
STATE OF FLORIDA STATE OF FLORIDA
•COUNTY OF SAINT LUCIE COUNTY OF SAINTUJCIE.,
Thefargoing instrunirentwas adknawledged.before me The fa ping instrulet7t W;w, acknowledged before me
this::l�tlay of S�,o f`' . 2i7 Eby thi ay of��2,�7' 20/1:by
JAMES W LAW JAMES W LAW
(P^e of person admowledging) (N of person acknowledging)'
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(Signature of Notary Public State of Florida) ( ignature of Notary Public State of Florida)
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type aflderrtification Pro.-du"cce/d Type of Identification Produced
Commission No: F !ifs 4463 Commission No. _�I� � (SeaQ,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETE
INITIALS
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