HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETrED FOR APPLICA'T'ION TO BE ACCEP'T'EDDate: �&7 Permit Numbe
E N-M
LO
Building Permit Application APR 18 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division ent
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie ntY, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial LEM -
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
-PROPOSED IMPROVEMENT LOCATION:-
Address: v 3 /Ve tt?el_r�_ />I/(,-11,
Legal Description:
Property Tax ID#: 1 clel 3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:_Right Side: Left Side:
[IXEIT�ILED'DESCRIPTION OF WORK:
Remove Existing Pedestal Replace with new
CONSTRUCTION INFORMATION:
AciciitionaiworKtooie-peeFFormecI under this permit—cnecK all apply:
®HVAC UGasTank DGas Piping InShutters a Windows/Doors;
EElectric El Plumbing 05prinklers 0 Generator Roof Roof pitch
Total Sq.Ft of Construction: SQ-Ft.of First Floor.
Cost of Construction:$ C/ r~ Utilities:OSewer F Septic Building Height.
OWNER/LESSEE: CONTRACTOR:
Name o ifs Name:Jahn R taw
Address: Company:-Larts Electrical Service Im
city: < .4 Y State: Address: 5168 NW Primm St
Zip Code: Z I 2--s-- Fax: City: Pt ST LUCID State:FL
Phone N o. 6__�,3u - 3 Gi U f 7 to Zip Code:34983 Fax:
E-Mail: Phone No.772 370 4357
Fill in feesimple Title Holder on next page if different E-Mail,1ohnlaw5158&oLcom
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.
l,-d LKe9L9zzLMV1 d6040 84 84 idV
SUPPLEMENTAL CONSTRUCTION LIEN LAW WFORMATION:
j DESIGNE-kJENGINEM- Not Applicable
MORTGAGE COMPANY: -Zklat Applicable
Name: Name:
Ad dress: Address:
City- State: City:
ZIP: Phone: Zip: Phone:
0!
FEE SIMPLE TITLE HOLDER: V Not Applicable BONDING COMP-4m..
- Nat Applicable I
Name: Name:
Address: Address:
CRY:
Zip: Phone: ZIP: Phone-.
OWNERI CONTRACTOR AFFIDVM.Application is hereby roadeto obtain a pernfitto do-the work and installatfan as indicated.
i certXyth-at no work or installation has commenced prior to be issuance of a permit
re
such
Assoc'rai5an and revievsr your deed-For any resfiristitcrns wlirch snap apply_•'• .
in consideration of the granting ofthis requested permit,I do haieby agreethat I Will,in all respects,perform the.iwork
in aces))-aantwanh tha'approved glans,the Madda Building Codes and SL Lucia CountyAmendments.
Thefollo'elng building permit applications are exemptfrorn undergoing-a full concurrency review:room addidom,,-
-accessory structures,sMmrr9ngPD0%fences,walls,signs,screen rooms and accessory uses to anath6r n6n-.re§deYWaJ use
WARNING To ()WNER-.Your failure to Record a HoUce of Commencement may result in your PEIV1119 twkefor
improvements to your property-A Notice of Commencement must be recorded and'posted on the jobske,
before the-fim inIsPecijOn-if you intend to obbim' financing,consult vAth lender or an attorney bef6m
commencing work or recording your Notice aF Commencement
-"
4
nature of erl AgeW ee signature
ContractorlUcense Holder
NE OF FLORWA
STATE OF FLORIDA STA
couwyor- ST. WCIE CaUffff Or- ST-WCIE
IThe was acknowledgmLliefore me Theforg0mg instrument was admowledged before me
by this_LZ_day of A-, / --,20,
iris day of 44r_-by
no 1prqentat'on t re
Ian Icable Ho;T atmar
-St L e Cou"Ir makes
j P
gich B;in con ctw Home P
Pie consult
V Ur om
e n
0 A
D ST-
nat r 0'
STATE of:FL
C I)N7Y or
0
r efora6- instrument ntwas-ati
h ins n
tlj.
day of
ja
(Name(Name Of person 2&vivzJ)adzing) (Name of person*M06ledgiIng
(Signature of Notary Public—State Of Florida I
personally Known __v OR Produced Idenfficadon Personally Known "-I✓ `OR Produced Identffication
Tv Of IdentfficaUcin Prodwed_
on
Type of Iden TVPL
Commission No. FF "
-T 9863 mission ivm
F 63 (Seal)
EBROWN
w
vl�1 ANNE BROWN WALMACH
MY COMNUSS10
MMIRSSMPA-21.2020 -MJb-bf0N FF964663
I F1orjda
Recdsed 0711512014 (4QEXPIRES Apill 21.202o3MO153 Nota22wvimamm
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW F011EIN REVIEW REVIEW REVIEW REVIEW
HATE -
RECE D
D
coMPLEMD
Z-d d6C40 91, 9l, AV