HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABLE INFO MUST BE COMPLETED FORAPPLICATION TO BE ACCEPTED _
Date: s1 Permit Number.
RECEIVED -_
s
Building Permit Application MAY 0 4 2
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Ger:u
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax.(772)462-1578 Commercial Residential 0
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:. ; -
Address: -7 U
Legal Description:
Property Tax ID#: �/ S—/ S'( U U�� UU Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove Existing Pedestal Replace with new
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CONSTRU ION INFORMATION:
Riona wo to a orme under this permit—check a appy:
0 HVAC 11 Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers 0 Generator 0.Roof !—.J Roof pitch
Total Sq.Ft of Construction: 5 Ft.of First Floor.
Cost of Construction:$ /f�l UC> Utilities:Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: John R Law -
Address: I -7 cu Company: LavWs Electrical service Ino.
City: State:M ILI Address:5158 NW Primm St
Zip Code: S )rti Fax: City: Pt ST Lucie State:FL
Phone No. Zip Code: 34983 Fax:
E-Mail: Phone No_ 772 3704357
Fill in fee simple Title Holder on next page(if different E-Mail:johniaw5l58@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.
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SUPPLEMEN►AL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERIENGINEER: Not Applicable [MORTGAGECOMPANY: Not.Applicable
f Name: Name- '
Address: Address:
City_ State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE Ht31.DER: Not Applicable BONDING COMPANY: Mot Applicable
Name: Name-
Ad dress: Address:
Cay- City:
ftp: Phone: Zip: Phone:
OWNER)CONTRACTOR AFFIDVIT:.Application is hereby madeto 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.Lurie County makes no representation that is granting a permituall authorize thepermitholder to build the subject structure
which is in conflict with any applicable Home Owners Assodation rales,bylaws or an covenants-that may restrict itr prohibit such
structure_Please consultwrth your Horne Owners Association and review your deed for any restrictions which may apply-
in consideration ofthe 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 Code.and St Lucie County Amendmerim
The following building permit applications are exempt from undergoing a fWI concurrency review:room additions,
accessory structures.swimming pools,fences,walls,signs,screen rooms and accessory uses t6 anothdr non-residential use
WARNING TO OWNER:Yom failureto Record a Noidce of Commencement may result irk 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 financir:g,consult with lender or an attbmey before
FSTATE
cin work or recordin ur Notice a;Commencement.
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os ner!Agent!Lessee Signature of ntractor License Holder
F FLOR#11A �-_LUCIE STATI:O FLOFtIIjA ST. LUCIE
COUNTY DF COUNTY OF
Theforgoing instrument was acknowledged-before me The fo oing instrument was acknowledged before me
this_,7- of ?_0_ X�bY this7day of P114 20,��by
{Na Ern of person a6mozOedg►ng) (Name of person a°eMtlbledging]
A*�4VA y public-State of Florida) (Signature of Notary Public-State of Florida]
personally Known OR Produced identification Personally Known '✓ 'OR Produced ldentrfication
Type of Identification Produced Type of Idertbf"ication Produllecl
Commission trio_ FF 98.4663y ( E BROWN WAL n-iionivo.. F y i63 (Sea[)
MY COMMISSION71 FF 63 ANNE$RowN WALMAC14
•,,u. EXPIRES Aptil 21.2020 MmF98"63
;4evised07115/2a14 (407'980, FloldaN ,'�°'^ EXPIRES April 21,2020
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE I
COMPLETED
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