HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INf/�]FO MUS!' BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. /o / %< `j,! f
Permit Number.
-
o
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential mo=
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LQCATl0N:
Address:
Legal Description:
Property Tax 11) t sGl�?, - C)3 elf, -000 -- S Lot .No.
Site Plan Name:
Block No.
Project Dame:
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION :OF WORK: -
tG Yl .S4 li��
�l
C7 s✓ 0,4 k,7
!
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit— Check
13
a apply:
HVAC Gas Tank E]Gas Piping
_ Shutters L1 Windows/Doors
ZElectric E] Plumbing Sprinklers
FI
Generator Roof
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
J
Cost of Construction: Utilities- 0Sewer OSeptic Building Height:
OWNER/'LESSEE: -
Ct)l1ITPACTC}R: I.
Name �f'�, f' rr q Js-L, /-
IVame:.lohn R few
Address: LaIL,
Company: Laws Electrical service Inc
City: Lz A, State: r-1
Address: 5158 NW Primm St
Zip Code: ��` Fax:
City_ PT ST Lucie State: FL
Phone No.
Zip Code: 34983 Fare:
E-Mail:
Phone No. 772 370 4357
Fill in fee simple Title Holder on next ,page ( if different
E-Mail: johniaw5158@aol.com
from the Owner listed above)
State or County License: 29432
u value o: cnnsuucuon is.>LJuu or more, a RECORDED Notice of Commencement is required,
SUPPLEMENTAL. -CONSTRUCTION LIEN € �II'lr t�if�RMAMOW
Not
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City= State:
Zip: phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
St. Lucie County makes no representation that is granting a,permit will authorize the permit holder to build tate 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 pians, 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 sof 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.
oe
ZY, s
Signature Owner/ Lessee/Agent Signature of Con658ctor%License Holder
STATE OF FLORNDAJ STATE OF FLORJDA
COUNTY OF C COUNTY OF /
The forgoing instrument was acknowledged before me
this ri r day of . 20 Eby
Of
The forgoing instrument was acknowledged before me
this4L day of c C4 20 by
n. np Al--6am W
F
(Name erson acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of ident%fication l�rodr�ced
r�
Commission T ' Commission No.� (Seal)
z .FK ANNE BROWN wALMACH
RevisedMA4 EXPIRES April 21, 2020 '� � MYCO M1 WALMACH
ROrf�NoWry$gryjpd can o. M SS10N # FF
rsorl ort 1:7{PIRES rr X683
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SE,4iGitQ
COUNTER REVIEW REVIEW REVIEW
REVIEW REVIEW REVIEW
INITIALS