HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t�
Date:
Permit Number:
-is
RECEIVED
Building Permit Application FEB 2 0 12` 1$
Planning and DevelopmentServices 1ST, L UC10 Gaui9ry, Permitting
Building and Cade Regulation Division -----
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential x*DU00m
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line!„\i,C_� �c q
PROPOSED IMPROVEMENT LOCATION:
Address: SC.2- c.P/e--,
Legal Description:
Property Tax 1D#: L/SO 2 -S'O 1 G t-e, -7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Sack: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove Existing Pedestal Replace with new
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit-check all Ihal appW.
HVAC Gas Tank ❑Gas Piping _Shutters E]Windows/Doors
RJElectric 0 Plumbing Sprinklers 1:1 Generator 13 Roof Roof pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ /,S-C C) Utilities:F Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name rZ,'l-'141"i -SLS .a v.: ., S f,, �2l,4 C"f* Name: John R Law
Address: Ll l, /V '-I y e k ,4 yr Company: Lawes Electrical Service Inc.
City: YL,, State:_tU Address: 5158 NW Priffn St
Zip Code: L �,:J 3 Tk Fax: c4,.4-v,G, City: Pt ST Lucie State:FL
Phone No. Zip Code: 34983 Fax:
E-Mail: Phone No. 772 370 4357
Hill in fee simple Title Holder an next page(If different E-Mail:johnlaw515B@aol.com
from the Owner listed above) State or County License: 29432
If iralue of construction is$2540 or more,a RECORDED Notice of Commencement is required.
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St3PPf EMENTAL-.CONSTRUGTION.LEEN LAW-JNFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address: -
City-_
State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Addi
city- CrtY
Zip: Phone: Zip: Phone:
certify that no work or installation has commencers prior to the issuance of a permit
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
vihich 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 1 will,in all respects,perform the vmrk I
in accordance wrth the approved plans,the Florida Building Codes and 5t Lucie County Amendments- i
The folio wing buiding permit applications are exempt from undergoing a full concurrency review:room admons,
accessory structures,sviimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residentiai 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 jl
before the first inspection-if you intend to obtain financing,consult with lender or an attomey before
commencing work or recording your Notice of Commencement-
Signature/Owner/
ommencement-Signature Owner/Lessee/Agent Signature of Co ctor/License Holder y
SPATE OF FLOR DA - STATE OF FLO f
COUNTY OF. Z(JC/[,2 COUNTY OF�
The forgping instrument w acknowledged before me The forgoing instrument was ac knovAedged before me
this dal,of _�� zo 1�� this &&j of .20 -(g �y
(Name of person acknowledging) / (rvame erson aGrnowledging) /
(Signature of Notary Public- o Florida) (Signature of Notary Public-State of Florida)
Personally Known K OR Produced Identification Personally Knowr. OR Produced Identification
Type of Identification Producers Type of Identification roduced
Ccmm"ission Commission No. (Seal)
ANNE BROWN WALM.ACH -�;,1:
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F:evised 7 4 ssrory ax 63
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TU GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIFN {
DENTE 1 1
COMPLETE j
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