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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO.BE ACCEPTED _O
Date: Permit Number: ( n
s - - RECEIVED
Building Permit Application
Planning and Development Services JUN 1-4 2018
Bullding and Code Regulation Division ST. Lucie County, Permitting
2300 IirginidAvenue,Fon:Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578• Commercial Residential xXaxxxXXX
PERMIT APPLICATION FOR: :To Select from dropbox,click arrow at the end of line 0 '
PROPOSED IMPROVEMENT LOCATION:-
Address: /12 H �/'� C7! is 1 �v7 -
Legal Description:
Property Tax ID M. L/ "a. I` l - OUy '� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks - Frorrt Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: / f
Jv c c-� •
CONSTRUCTION INFORMATION:
itiona wor to e e Orme under t ►s permit-checka appy:
0HVAC 13 Gas Tank ❑Gas Piping _Shutters I_...i Windows/Doors
Electric a Plumbing Sprinklers Generator a Roof Roof pitch
Total Sq.Ft of Construction: S .Ft.of First Floor:
' rJc
Cost of Construction:$ �' r;o Utilities: Sewer aseptic . Building Height:
-OWNER/LESSEE: CONTRACTOR:
Name r)r= Name:John RLaw
Address: 1.2 lfIc tfl.,s j3 -P Company: Law's Electrical Service Inc.
City:_Te H_�C+, i e-4 4.L^ State: ( Address:
5158 NW Primm St
Zip Code: 3 Y 1_5-2 _ _ Fax: City: Pt ST Lucie State:FL
Phone No. L{ - l 17 Zip Code: 34983 Fax:-
E-Mail: Phone No. 772 370 4357
Fill in fee simple.Title Holder on next page(if different E-Mail:john1aw5158QaoLrom
from the Owner listed above) State or County License:29`132
If value of construction is$2500;or more,a RECORDED Notice of Commencement is required.
`✓'d LVSC9L8ZLLMV•l e8E:80 86 t6 ung
SUPPLEMEN i AL CONSTRUMON,LI%LAW INFORMATION:
DESIGNERfENGINEER: Not Applicable PAORTGAGE COMPANY: Not,Applicable
Name
Address: Address-
Clty: State: City: State: T`
zip-- Phone.- Zip: Phone:
FEE SIMPLE Wag HOL.DFk: Not Applicable BONDING COMPANY-. Not Applicable
Name_ Name:
Address Address-
Ctly: may=
gyp: Phone: Zip: Phone:
OWNER/GONTRACrORAFFIDVIT:.Application is hemby made to obtain a pernsitto do-the workand installation as indicated.
I car+ufy that no work or installation has commenced priorto.the issuance of permit.
st-Lucie Courty makes no representation that is granting a permit will authorizethe permit hoiderto build the subjectstru.cture
l
which is in con ict with any applicable Home Owners Association rules,bylaws or anti covenants that may restrict,or probl it such
tru
scture.Please consult Willi your Nome Owners Assadatibn and review your deed for any restrictions which May apply_-
in cansideration of the grantrng of this requested permit,I do hei-ebyagreethai I will,in all respects,perform the work.
in accordanceidah the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exemptfrom undergoing a full concurrency review:room additions,,
ac rsory strictures,swimming pools,fences,walls,Signs,screen rooms and accessory uses.to another non-residential use
1?1tARli)ING TO OWNER:Y+ou rfaRureto Record a Notice of Cosritnencementuay result inryour paying twicefof
improvements to your property_A Nol ice of Commencement must be recorded acid-posted on the jobsite
before the first inspection.If you intend to obtain financing,consult Vvith lender or an attomey before
commencing work or recordinity2ur Notice of Commencement.
[�thh—&JaVcif'
sture nerl Agent/Lessee Signator f Cantractor/License Halder
TE OF FLORIDA - LUCIIr STATE OF FLORIDA ST.LLICIIr
UNTY OF COUNTY OF
forgoing instrumentwas acknowledged before me ,The forgoing instrument was acknowledged before me
�=�r1�L�; .z0 by this ,day of ' ti _ 20,1-1;7--bp
(Name of person admanftdaing) (Name of person a°dd%%ledging)
(Signature of-Alotary Public-State of Florida) (Signature of Notary Fublir=State of Florida}
personally Known `✓✓~ OR Produced id_entisication Personally Itn4wn I," 'OR Produced Identrl'ication
Type of Identnfccatlon Produced Type of Idenbf-ncation Produ=
cornmission No.�FF 98"63 - ,�r,y�+( E BROWN WAL rinission too. F 63 � (Seal)
;.�, -
•'; MY COMMISSION OF 83 ;;a' ' w ANNE BR©WN WALMACH
EXPIRES Apn121,282Q F98{653
EXPIRES
(107}�98-ot5'� Ffow+�No� ervice.a�m 'i±..•••' Ap ri121.2t12Q
Remised 0711512014 taarla9sois3 FanmMoenrs�, ,.�,
REVIEWS !CO
NT" EREVIEN
SUpERVI5OR PLANS ' VEGETATION SEA TURTLE MANGROVE
t TERMIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
i�ATE
CpIU1PLEIED
l,•d -89Z6-b�9-698 L�81;8L8ZLLMH� abE�80 8L b.t! unf