HomeMy WebLinkAboutBUILDING PERMIT 0
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- I(a Permit Number:
S _1
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
23001Trginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential xxx�cx
PERMIT APPLICATION FOR: To Select from dropbox, elicit arrow at the end of line
PROPOSED-IMPR011EMENT LOCATION.
Address: lv S-U e",
i
Legal Description:
Property Tax ID#: -S-02 - S G i G 3 (5, G U o a Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPT MOE WORK,
remove existing pedestal install new
CONSTRUCTION INFORMATION:
A001tional work to bie nartormed under is permiE—Zfiea all app ..
[]MVAC Gas Tank 0GasPiping _Shutters Windows/Doors
21 Electric 0 Plumbing ❑Sprinklers 0 Generator E]Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor.
Cost of Construction:$ � -'_ _. Utilities: Sewer Septic Building Height
OWN ERAESSEE CONTRACTOR:
Name u V1 y y r�, c� 1' Name: John R Law
Address:--LC- v„- r r f -/ Company: LaWs Electrical Service Inc
City: J cH S e-, Y_3z,�c,1, State: !`-/ Address: 5158 NW Primm St
Zip Code- �'t 5.7-- Fax: City: PT 5T Lucie State-FL
Phone No. Tip Code: 34983 Fax:
E-Mail: Phone No. 772 370 4357
Fill in fee simple Title Holder on next page(if different E-Mail: johniaw5l58@aol.com
from the Owner listed above) State or County License: 29432
U value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN I:Atl11 INFORMATION` -
QESIGNERJENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDEN: 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 Horne 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 perit,I do hereby agree that 1 will,in all respects,perform the work
in accordance with the approved plans,the Florida B ilding Codes and St.Lucie County Amendments_
The following building permit applications are exemp from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls, igns,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 ommencement must be recorded and posted on the jobsite
before the first inspection. If you intend to o�tain financing,consult with lender or an attorney before
commencing work or recording our Notice f Commencement.
s
_Signature Owner/Lessee/Agent Signature of Con or/License Holder
STATE OF FLOR 8A STATE OF FLO
COUNTY OF C COUNTY OF
� (�
The forgoing instrument was acknowledged before m The forgoing instrument was acknowledged before me
this LOL day of Z(3 by this day of S 20 J ?by
L2 n(21LL Ltl Q'JM0 r
I ► Js 1 ���I [�d
(Name f person acknowledging) I (Name erson acknowledging)
Ow
(Si nature of Notary Public-Sta&o6t 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 I�roduced
cam.
Commission Y I Commission No. (Seal)
ANNE BROWN WALMAGH
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Revised ? '�4 EXPIRES April 21,202o MY�OMMI5Sr N WALMACH
Plnndekooeryserv;pa.eo,n l�orj FJCPIRES ON#FF2g¢683
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA Tt AIGROVE
COUNTER REVIEW! REVIEW REVIEW REVIEW REVIEW REVIEW
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