HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ITO
Date:
'T• Jam'?•)U Permit Numbe
11111M1 a%, I
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Building Permit Application APR 13 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential x*00
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPQSED IMPROVEMENT LOCATION
- _. .
Address: C) 6 vJ'
Legal Description:
Property Tax ID#: 1-/S_OP, - S-0 j— 0,U el — G U U-- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Y }
DETAILED DESCRIPTION.QF WORK T{ xf _ a
Remove Existing Pedestal Replace with new
CONSTRUCT ON INFORMATION _
Additional work to be Dertormed un er t is permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
P]Electric Plumbing ❑Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq.Ft of Construction: S of First Floor:
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Cost of Construction:$ 4o GU Utilities-11Sewer Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name d , Name: John R Law
Address: /3 0,U S cu ���'`�/}uG ,/7.o f L/�z Company: Law's Electrical Service Inc.
City: State: f--f Address: 5158 NW Primm St
Zip Code: 3 3 1710 -17/7-Fax• City Pt ST Lucie State:FL
Phone No. 20T -7Y.2- - `7S-OCJ Zip Code: 34983 Fax:
E-Mail: Phone No. 772 370 4357
Fill in fee simple Title Holder on next page(if different E-Mail:johnlaw5158@aol.com
from the Owner listed above) State or County License: 29432
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW f_NEORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
4
City: State: city: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFiDVIT:.Application is hereby made to obtain a perrnitto do-the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit
St-
t L
uae C Sun makes no representation that is granting a permit wi71 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 iestrict.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 work
in 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 usesto.anothdr non-residential use '
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice fol
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
commencin work or recordingvour Notice of Commencement_
L'
Signature of ner/Agent/Lessee Sign of Contractor/License Holder
STATE OF FLORIDAST.LUCIE • STATE OF FLORIDA
COUNTY OF COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged-before me The forgoing instrument was acknowledged before me
this _day of v, / .20by this_J_Z_day of ��• I .2U by
1P L Ayd2
(Name of person aft mRedging] (Name of person a''eltne fledging]
(Signature of-Notary Public-State of Florida) (Signature of Notary Public-State krida)
Personally Known '✓ OR Produced Identification Personally Known '✓ OR Produced Identification
Type of Identification Produced Type of Identification Prodwed
Commission No_ FF 984663 , • �;; ,{ mission Ivo- F 63 (Seal)
--- E BROWN WAL •�»
•': MY COMMISSION t!FF 83
;R'�••'t ;: ANNE BROWN WALMACW
'•.,,o: •�,•• EXPIRES April 21,2020 P11 8 FF9W63
Revised 07115/2014
(407)398-0153N� �.� •. , EXPIRES April 21,2020
(407)398-0153 Fbrl6tNola arviop.p�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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