HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -�f c///.f Permit Number: '
• RECEIVED
Building Permit Applicatio
Planning and Der.�elapmentServices MAY 10 218
Building and Code Regulation Division ST. Lucie Count p
2300 Virginia Avenue,Fort Pierce FL 34982 v, ermitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential �-
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: i(-) 1,. r ..S' U c ell- vt V
Legal Description:
Property Tax ID#: �'/�//' S'—� f G C J-5— Z'Ci 3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove Existing Pedestal Install new 150 amp meter combo pack on 2" alum strut stand
[L(111V --g-/I i /
E-ONSTRUCTION INFORMATION:
Additional work toe e Orme un er this perm —check a apply:
HVAC E]Gas Tank OGas Piping _Shutters O Windows/Doors
Electric Plumbing OSprinklers O Generator L�Roof Roof pitch
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ Utilities:Li Sewer OSeptic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name S frvc 4-- T-e4- i,r. 1'YI�, .� �n✓ 'c-C, Name: John RLaw
Address: %V "7.ZS- So.J t, GCe•xh W1,L S`/o Company: Law's Electrical Service Inc.
City: .1',., s c !fir AC-L, State: r--�f Address: 5158 NW Primm St
Zip Code: S"I el>7 Fax: City: Pt ST Lucie State:FL
Phone No. 21 "i Z e? J U 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.
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SL PPLI=MENTALCONSTRUCTION LIEN LAW JNFORMATION:
DESIGNER/ENGINEER: �NotApplicable MORTGAGE COMPANY: _Not Applicable
Name: I Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Nat Applicable
Name: Flame:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certi`y that no work or installation has commenced 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
which Is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consultwith your Home Owners Association and review your deed forany restrictions which may apply.
In consideration cf the granting of this requested permit,I do hereby agree that I 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 reviem room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential 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
before the first inspection.If you intend to obtain financing,consult with lender or an attomey before
commencing work or recording our Notice of Commencement.
I
s
_Signature Owner/Lessee/Agent Signature of Con' ctor/License Holder
STATE OF FLORP3AJ STATE OF FLOMDAs
COUNTY OAF cy (K 1P COUNTYOF Lop
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thi�day of i1^.�� 20 J�by this day of 20 �by
(Na
f person acknowledging) (Name arson acknowledging)
r
(Signature of Notary Public-S=6 of Florida) (Signature of Notary Public-State of Florida)
Personally Known 'k OR Produced Identification Personally Known _OR Produced Identification
Type of i6entification Produced Type of lderrtification Rroduced
Commission r y Commission No. ��� (Seal)
rte• 'Y ANNE BROWN WALMACH
Revised �,f EXPIRES APO 21,2D20 ' My cc,um wALMACh
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r�o�1�e.o, SIRES SDN for 83
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TU }VGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS
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