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Building Permit Application
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3 Permit Nu D7�b 0-7 o RECEIVED ua-i i-M OEM-BMW Building Permit Application JUL 3 2018 Planning and DevelopmentSemices Building and Code Regulation Division Permitting Department 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL Phone:(772)462-1553 Fax: 772)462-1578 Comm rc at PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPR01[EMENT LOCaTtON _ Address: 12 -201 S o U 1, 06 r. Legal Description: Property Tax ID f �/ / j - ,�'/U O G 7 G QG o ^ Lot.No. Site Plan Name: Block No. Project Name: setbacks Front Back: Right Side: Left Side: DEQ'AILED-DESCRIPTfON O;F remove existing pedestal install new 150 amp meter combo pack CONSTRUCTION INFQRMATION. Additional work to be e rme un er permit— ec a apply.- HVAC El Gas Tank [:]Gas piping _Shutters ❑.Windows/Doors PlElectric 0 PlumbingSprinklers 1:1 Generator El Roof Total Sq.Ft of Construction: S .Ft of First Floor: Cost of Construction:$ 7 C>U Utilities:IlSewer[]Septic Building Height: OUVItER/JESSEEt CONTRACTOR• Name ,1 Y h n IT 10 S Name.• John R Law Address. 3�i 1 `-1 L h C- f--.v-4- Or L Company: Laws Electrical Service Inc City: S « 1�'�, !�tr �l State:( Address: 5158 NW Primm St Zip Code: _�1'? 1 �( Fax: city PT ST Lucie State:FL Phone No. Zip Code: 34983 Fax: E-Mail: Phone No_ 772 370 4357 Fill in fee simple Title Holder on next page(if different E-Mail:johniawSISB@aol.com from the Owner listed above) State or County License: 29432 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCrION LIEN LAW l_NFORMATfQN;- �ESIGNERfENGiNEER: NotAppSicabSe MORTGAGE COMPANY: ;-tol '-Applicable } dame: Name: Address: - Address:. , city: State: City: State: Zip= Phone: zip- Phone: } FSE SIMPLE TrrLE HOLDRIk. r NotAppiicable BONDING CO11ltPANY; NotAppticable Name: Name: Address: Address: City_ City_ yip: Rhone: dip- Phone: OWNER/COPURACrOR AFF11DVIT.Application is hereby rnade-t i obtain a perrnitto do-the work and installation as indiicated'. I certify that no work or installation has commenced prlorto the issuance of a permit St.Lude County snakes no representation that is granting a permit will authorize thedpermit bolderto build the subjectstructure which is in conflict with airy applicable Home Owners Assogatron rules,bylaws or an covenants that may restrict.or prohibit such structure_Please consult* your Home owners Association and review your deed for any restrictions which Fray apply_, in consideration of the granting of this requested permit,l da hereby agree that i will,in all respects,perforin the work- in accordancewith the approved plans,the Florida Building Codes and St Lucie County Amendments. - Thefollowingbuilding permitapplicationsare exemptfrom undergoingafull concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory usesto anotiidrnon-residential use W ARNING TO OWNER:Your fm1ure to Record a Notice of Com menceMent may result inyour P►ayuutg t'0Ace for improvements to your property_A Notice of Commencement must be recorded and-posted on the job$ite before the first inspection.If you intend to obtain Finan©ng,consult with lender or an attorney befdre - Commenting work or recordinizvour Notice of Commencement. Signature of O erj ge Lessee 5gnature of ontractorlr icense Holder STATE OF FLORIDA , LUCII~ ` STATE OF FLORIDA �c-J- LUCIE CC}1)NTY or. COUNTY OF The forgoing instrumentwas acknowledged before me Thefo ding instrurnt ent:r,,ras ack riowledged before me this S day of �'j �. 2Oby this day of „1 {Name of person adc ealledging) (Name of person fledging I - L ae _ It _ {Signature ofNotary Public-State of Florida) Wignature of Notary Public State of Florida} Personally Known V OR Produced Ideniiicadon Personally Known ✓ `OR Produced Ideniisication Type of Iden#m'cation Produced - Type of Identillcation Prod�saed Commission No. FF 384563.•; ;;; •( E BROWN WAL » mission ivo F 63 (Seal) '= MY COMMtSS3dW#FF I �? ANNE BROWN WALMACH =••" '''•.o;,...*' EXPIRESApsi121,2020 d t+o�39"153 FW0aRcbry8*M=.eam '•a°,;;':�` EXPIRES April 21.2020 = Revised 0711512th_ wo»ase orss REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW - REVIEW REVIEW REVIEW REVIEW REVIEW - RECEIVED DATE # COMPLETED i