HomeMy WebLinkAboutBuilding Permit Application N
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c
Date: o o l'9 Permit Number:.
REC6 E
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, AUG ,��` � ,
Building Permit Application �s9
Planning and Development Services Sr. Lucie County,
Building and Code Regulation Division �' Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbo,�, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: O
Legal Description:
Property Tax ID#: /3S 00>6 -a Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to MGasTank
orme un ert ispermit-c ec a appy:
HV ❑Gas Piping _Shutters Windows Doors
a ,
_Electric Plumbing Sprinklers Generator Roof F-1Roof pitch
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction: Utilities Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: James W Law
Address: O 1�' Company: Law's Electric, Inc.
City: State:,-7V Address: 218 Beach Avenue
Zip Code: Fax: City: Port St.Lucie State: FL
Phone No. Zip Code: 34952 Fax: 772-878-3347
E-Mail: Phone No. 772-971-4512
Fill in fee simple Title Holder on next page(if different E-Mail: lawselectricinc@aol.com
from the Owner listed above) State or County License: ER0000122
ff value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION:LIEN.LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address- Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: , rNot Applicable
Name: Name:
Address: Address:
City: 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 anyy applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult au
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 acIditions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
"WARNING TO OWNEIC 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 JOB SITE BEFORE THE FiRST INSPECTION. IF YOU INTEND TO OBTAiIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
nature of Owner/Lessee/Contractor as Agent for Owner Si tore of Contractor/License Molder
STATE OF FLORIDA T /,� -- STATE OF FLORIDA ; J
COUNTY OF COUNTY OF
The forgoing instrumen was acknowledged before me The forgoing instrument was acknowledged before me
this 1- day of c,` 20Z?by this/ day of '4L" 20 6F by
Name o person making statement. dame o person making statement.
Personally Known OR Produced Identification Personally Known OR Produced identification
Type of identification Type of Identification
Produced Produced
{Signature o E'e JS ISS Florida) {Si nature 91 swWorida}
o�,NOTARY PUBLIC Q =NOTAFRY PUBLIC
Commis RIDA{Seal} Commiss� 4 nF ORiDA (Seal)
Comm#GG262780 "' Camm#GG262780
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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COMPLETED
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