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HomeMy WebLinkAboutBuilding Permit Application ALL APPUCABLE INFOO MUST BE COMPLETED FOR APPUCATlON TO BE ACCEPTED \ Data: 1 Permit Number:"'1 IQ' O 5 5S � . S J _ • z :7 E 4111111-7 - Building Permit Application DEC2 1 201 l Planning and DevdapmenrServtces Building and Code Regulation Division 2300 trg nia Avenue,Fort Pierre FL 34-W RP�5i�e11ti81 ._ . Phone:(772)462-1553 Fax:(772)462-LWB Commercial PERMIT APPLICATIQN FOR- To Seledirom dropbox, dick arrow at the end of fine PROPOSED IMPROVEIVIt OLCATtON - Address: 3 ,Z (, ZV G 17 l -ej Legal Description: Property Tax ID#: Site Plan Name: Block No- Project Name; Setbacks Front Back Right Side: Left Side- 7. DETAILED DESCRIPTION OF WORK remove existing pedestal Install new CONSTRUCTION INFORMATION: AdditiDnalWo—rktD ertormeoun permit—tapW. . HVAC Gas Tank 0Gas Piping _Shutters (l Windows/Doors ZElectric Q Plumbing ❑Sprinklers E,Generator Roof Total Sq.Ft of Construction: Ft.of First Floor. Cost of Construction:$ FFG u Utili ies[]Sewer[:]Septic Building Height: OWNERAESSEE: CONTRACTOR _ Name r v Name: John R Law Address: k k' ,9"0 C. Ge'c a v 10/'k- Company: Law's©eclsscal Service Inc City: f,-j4 i C'--n J�c�► !^ State:�{ Address: 51'58 NW Primm St Zip Code: _7�/�I S 7_ Fax: may. PT ST Lucie State:Fl- Phone No. Zip Code: 34683 Fax : E-Mail: Phone No. 772 370 4357 Fil l in fee simple Title Bolder on need page(it dMererst E-Mail: john1aw5158@ao1-com from the Owner fisted above) State or County License- 28432 R of construction is$2500 or more,a RECORDED Notice of Commencement Is required. Z-d -89ZL-L99-L99 L1?£68L8ZLLMbI evz:M LL OZ 080 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNERIENGINEER Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: ( Zip: Phone: Zip: Phone: FEE SIMPLE TITLE BOLDER: Not Applicable BONDING COMPANY: _Not Applicable Name:i Name: Address: Address: City- _ City: Zip: Phone: Zip: Phone: 1 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 ir,. 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 the first inspection. If you intend to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement. _ Signature/ ignature Owner/Lessee/Agent Signature of Con ctorJLicense Holder i STATE OF FLOR ASTATE OF FLOWDA COUNTY OF c . Lft6l' COUNTY OF 1 UCIP The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this_day of 20 _by this_ — day of 20 _by (Name f person acknowledging) f (Namealperson acknowledging) ' � s I (Signature of Notary Public-Statle of 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 Rroduced Commission f Commission No. /pE� (Seat) :Fr ANNE BROWN WALMACH N Revised �' �4 EXPIRE 21.2020 4 i+�y Co CN aoJo, 'lieg X663 REVIEWS f FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TUU GROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS 8 d -89Z 6-699-699 Lb888L8ZLLMd� ebZ O l Z1, OZ 080