HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TOB E ACCEPTED Q 2
Date: Permit Number: l b��•�3 J�
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 404 N 38TH STREET,FORT PIERCE,FL 34947
Legal Description:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
'�',DETAILED'DESCRIIPTION:OF°WORKa
REPLACE EXISTING METER RISER AND GROUNDING SYSTEM FOR A NEW ONE
,rCONSTRU,CTIO.N.INFO�RIVIi4►►TlON. ` _ ''
Additional work to be nertormed under this permit-check all that a p y:
1IHVAC Gas-Tank E]Gas Piping _S iutter,s a Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1,300.00 Utilities: Se er Septic Building Height:
"OWNERKESSEE CONT ACTOR:'
NameLISAVPAES NJbVeS Name: FUBLIOSTERLING
Address:404 N 38TH STREET, Compan : ivIP,. ECEGTAIG or-OsC,
City: FORT PIERCE State:FL Address: 5994 NW BAYNARD DRIVE
Zip Code: 34947 Fax: City: PO RT ST LUCIE State:FL
Phone No.,772 812 5066. Zip Code 34986 Fax:
E-Mail: Phone N:). 772-777-0939
Fill in fee simple Title Holder on next page(If different E-Mail: r.electric.psi@gmail.com
from the Owner listed above) State or county License: ERI 3015179
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
I
01 1, 07,1 Woo A
OIL M,Wo
7 Mika :;J VAT ?A
�g,VV 7
n vb%N Owl ypin-
st
SUPPLEMENTAL CONSTRUCTION LIEN'LAW INFORMATION'.
DESIGNER/ENGINEER: _
Not Applicable MORTIS kGE COMPANY: Not Applicable
Name: Name:
Address: Address
rItv. _ State: City: State:
Lip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDIN'COMPANY: —Not Applicable
Name: Name:
Address: Address: I
City: City: I
Zip: Phone: Zip: I Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtai i a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of; permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaw or and covenants that may restrict or prohibit such
structure:.Please consult with your Home Owners Association and review you deed for any restrictions which may apply.
In consideration of the granting of this reauested hermit,I do hereby agree that 1 will,in all respects,perform the work
in accordance with a Bc aNNB wcu 3L.Ducie county Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and aaccessory 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 attorney before
comm–enciag work or refordirAg your Notice of Commencem
Signature of Owner/Less P` gent ror owner Signature of Contractor/License H
STATE OF FLORIDA _- F FLORIDA
COUNTY OF _ COUNTY OF
The forgoing instrument was acknowledged before me The forgIg instrument was acknowledged before me
this day of 20_ by thiis���\�\�J a�y�of� .�20_ by
Name of person making stateme fume of person making state nt �
Personally Known OR Produced Identification Personally,Known OR Produced Identification
Type of Identification Type of Identification
ProducedProduced
- . l
(Signature of Notar&ublic-State of F ida)__. ,- (Signature of Notary Public-State Florida)
L.ASHANNA INGRAM, .• _.IY
c � p
II I Commission No. 13=°a�\<=. NotaryN@01)-State of Florida l Commission No. (Seal)
II _°«
14°c My Comm.Expires Dec 20,2018 -
1� Commission#FF 177249 J �=
OFF��,� nANNA INGRAM
u u 1 •:auu 11 la I . .,Ryp
I• I _ - Notary F ublic State of F1') a
tttVItVUJ i KUN1 LUNINC� SUi'tRVISUtt PLANS VtGttAiir ?.2�,°� 13R7TjI��omrI.MANGROVE 2018
COUNTER REVIEW REVIEW REVIEW REVIEW tw Com issilREVIEW77249
DATE %,P,;; Bonded ttt ougn r;auur.l I@utai %Mn
RECEIVED
DATE
COMPLETED
Rev.8/2/17