HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o� 1 I tl�d Permit Number: 1
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twig Building Permit Applicatio13 2018
Planning and Development5ervices unty,Parrnitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine
PROPOSED IMPROVEMENT LOCATION:
Address: 11 .?S /Vc- {f/,, 6 1 v Z
Legal Description:
Property Tax ID#: ��S�O - S-0 I - / -7 Z z-Ci C'0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
FDETAI LED DESCRIPTION OF WORK:
Re-move Existing Pedestal Replace with new
CONSTRUCTION INFORMATION:
Xi itiona workto a rm under is permit-check a appy:
0HVAC 11 Gas Tank []Gas Piping Shutters Windows/Doors
R.I Electric F Plumbing ❑Sprinklers 1-1 Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq,Ft.of First Floor:
Cost of Construction:$ t C'U
Utilities: Sewer El Septic Building Height:
0�11lNER/LESSEE: CONTRACTOR:
Name Fr Name: John R taw
Address: S-<.' f A- f!, ✓+ I i c rL Z Company: Law's Electrical Service Inc.
Citv: .S wr ` State: 11"4 Address:5158 NW Primm St
Zip Code U 1 (, j- Fax: City: Pt ST Lucle State:FL
Phone No._I-S-0 8 - Zip Code: 34983 Fax:
E-Mail: Phone No. 772 370 4357
Fill in fee simple Title Holder on next page(if dt ferent E-Mail:j0hn1aw5158@80l.c0m
from the Owner listed above) State or County License: 29432
If value of construction is$2500 or more,a RE-CORDED Notice of Commencement is required.
£'d -8926-199-699 Lt££9L8ZLLMVl e££:60 9L Cl, qac
. IJPPLEMENTALCONSTRUC ION PEN LAWJNFOR;;1/fATiO(t! =
1
j 12ESI6NER/ENGINEER: Not Applicable MORTGAGE COMPANY: !Not Applicable
Name: Name: I
} Address: Address:
City: State: city: State:
i_1p: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Carne: Name:
Address: Address:
City-_ Gly: - I
['.ip: Phone: Zip: Phone:
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I certify that no worts or installation Pori commenced prior to-the issuance of a permit
S`.Lucie Counttyy mattes no representation that is granting a permit will authorize the permit holder to build the subject structure
to hich Is in conflict with any applicable Home Owners Association rules,bylaws orand Kvenants that may restrict or prohibit such �
slructure.Please consult with your Home Owners Association and revievr your deed for any restrictions which may apply-
Ir consideration of tate granting of this requested permit I do hereby agree that 1 will,in all respects,perform the work �
it accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
Tie following building perms applications are exemptfrom undergoing a full concurrency review..room additions, l
accessory structures,swimming pools,fences,vialls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your Failure to Retard a Notice of Commencement may result in your paying twice for
improvements to Void,property_A Notice of Commencement roust be recorded and posted on the jobsite
before the first inspection-If you intend to obtain-Financing,consult with lender or an attomey before
o)mmencin work or recording our Notice of Commencement.
_Signature Owner/Lessee/Agent Signature of Con ctor/License Holder lit
SPATE OF FLOR A l - SPATE OF FLO
CDLINTY OF _ �''(iC/P COUNTY OF -c!P I
The forgoing inammenttwas acknowledged before me The forgoing instrument was adnovl]edged before me
this�k day of F 20 J)26y this day of 20 l�2_by
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(Nam7personacknowledging) [Name erson acknowledging)
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(Signature of Notary Public-Sta Florida) (Signature of Notary Public-State of Horida)
Personally Known OR Produced Identification Personally Known OR Produced identification
Type of identification Produced Type of Identification duced
n
Commission ��� (So Commission No. (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATFON SEAQ U GROVE
COUKITR REVIEW REVIEW REVIEW REVIEW j REVIEW REVIEW
DATE
COMPLETE
INITIALS c
d -89Z1-L99-199 Lb££8L8ZLLMd� e££60 81, £l Qad