HomeMy WebLinkAboutBuilding Permit ApplicationALL APPUCABLE 1 O MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED
Date: Permit Number:
•
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 mco=
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
c_,/
Property Tax ID #: I S u Z- (I f l Z u U Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Block No.
remove existing pedestal install new 150 amp meter combo pack on 2" alum strut stand
]amonal worr, W ue wriorivieu
1JHVAC
1.111=1 LIM �=11111t— VueLn an
E]Gas Piping
apply.
Shutters
Q Windows/Doors
Gas Tank
Company: Law's Electrical Service Inc
_
Address: 5158 NW Primm St
ZElectric 0 Plumbing
❑Sprinklers
Generator
Roof
Total Sq. Ft of Construction:
C✓ C
Cost of Construction: $
Sq. Ft. of First Floor. _
Utilities. 0 Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR.*;
Name,
Name: John R Law
Address: l (.� `-� U S w l l�� L -l- /7 i'C
Company: Law's Electrical Service Inc
City: r_ f State:
Address: 5158 NW Primm St
Zip Code: L/ 67 ,k % Fax:
City: PT ST Lucie State: FL
Phone No.—/
Zip Code: 34983 Fax:
E -Mail:
Phone No. 772 370 4357
E -Mail: johnlaw5158@aol.com
Fill in fee simple Title Holder on next page ( if diffierent
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 CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:_
City: State:
Zip: Phone
Address:
City: State:
Zip: Phone: _
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
BONDING COMPANY: Not Applicable
Name:
Address:_
City:
Address:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify 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 holder to 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 consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of 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 review: 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 attorney before
commPnrinp work or recordine vour Notice of Commencement.
Rev. 8/2/17
Signaty,✓e of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
7 20J_�7by
this day of , :!� 20 � J by
this day of _� >
Name of person making statement
Name of person making statement
Personally Known . OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Si g nature of Notary Public- State o
of Notary Public- State of Florida )
o`'"+`°° RACHEL
DAVIS
Commission No. ' 4 ;
My COMMISSIO
9PN@*§io
I No. '� ` s .P
EXPIRES Janu
try 5, 2019
.. °
fes•.= RACHEL M DA%
(407) 399-0153 Flon dallotarySq
rvice. com
•o
MY COMMISSION #FF1i
••.,,ost�,,;+'.EXPIRES January:5,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
) t 6Q4IEe.0
REVIEW REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17