HomeMy WebLinkAboutBuilding permit application AN APPLICW INFO MUST BUCOMPLE!•ED FOR APPLICATION TO BE ACCEPTED
Permit Numbers
Building Permit APPfication
Planning and Development Services
Building and Code Regulatfon Division
231X►WgInIsAvenue,Fort P/arw-A30W
Phone:(772)462-2553 Fax:(772)462-1578 Commercial Residential XXXXXXXX
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: /07.�. l3Gr.�� IY.Ip'L
Property Tax ID M, _ Y SII S'U I G j(Q k _00a y „_,_i, Lot Nolow"
Site Plan Name: 81ock,No.
Protect Name:
fD7ETWW0 DESCRIPTION OF WORK:
42 Ltrr
vc-
CONSTRUCTION INFORMAnON:
Additional work to be performed under thl,permit–check all that apply:
,,,_Mechanical _Gas Tank _Gas Piping —Shutters �Windows/Doors
—,Electric ,+Plumbing Sprinklers —Generator Roof _Pitch
Total Sq.Ft of Construction: Sq.Ft:of First Floor:
cost of Construction: /....5 0 a Utilities: _Sewer _„_Septic Building Height:
OWNERABSEE: CONTRACTOR:
NBttle ta,,'r,yd._ L Sye►,.�rn IT r Name;John Law
Addrass: 7 S 3 gg.,t,s 4 Ggofr s C J: _ compleny:L!Ws elec wcal Semce Ina
City: 'G✓1 I L:t viaI/„� State:P_ff Address-5158 NW Primm St
'iip Codes 412 G fir/ Fax: City: Pt St Lurie State:Fl;,_
Phone No. / U 2-–� 9 6 'tU1-Z - Zip Code:34983 Fax:
Mail.• Phone No 772 370 4367,
FII in tee s;mple't de Holder an nem pse(If different . F_MailJahn aw5156QedLcM
from*9 Owner llsWd above) State or County License EC 1300!1370 28432
if value of on:truction Is$2100 or more,a RECORDED Notice of Commencement Is required.
N value of HVAC b$7,500 or a Wm'a RECORDED Notice of comeiencement Is repaired.
i
I
All APPLICABLE INFO MUST BE COMPLETED FOR, APPLICATION TO BE ACCEPTED
Date; =--- `L 1z ;t Permit Number:
Planning and Development Services
Building and Code Regulation Dlvislon
2300 Virginia A venue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Building Permit Application
Commercial Residential xx ooa`xx
Address: /0 7)� S S 0Ct't h VJl2 AE:
Property Tax ID #: L/ S! l SU / C) i CJGC/ Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit –check all that apply:
_Mechanical
_ Gas Tank
_ Gas Piping
_ Shutters
—Windows/Doors
Electric
_ Plumbing
_ Sprinklers
_ Generator
—Roof Pitch
Total Sq. Ft of Construction:
UU
Cost of Construction: $ / SU
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Building Height:
OWNER/LESSEE: I CONTRACTOR: I
Name w 11 < _ 1 d- S -/,n a,4,y /r
Address: 0-1-
City: W,( F l/r State: 1z`
Zip Code: 'J 7 G,k/ Fax:
Phone No. 1- / `I — Z 9 6 — / Z z L
E -Mail:
Fill in fee simple Title Haider on next page i. If different
from the Owner listed above)
Name;John Law
Company: Laws Electrical Service Inc.
Address: 5158 NW Primm St
City: Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail)°hn1aw5158(d�aot.com
State or County License EC 13006370 29432
if value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required,
if value of MVAC Is $7,500 or more, a RECORDED Notice of Commencement L^ required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone
State:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 Countv makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co Mict 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
ing,work or recording our Notice Or L.Ommencement.
of Ownei/ Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 19 day of i'* 203( by this Ld day Of %rA7 .202 by
Name of person making statement
Personally Known _,z' OR Produced Identification
Type of Identification
1
(Signature of Notary Public- State o
Commission No. "� F \h, ' -> \
190]1 TJB-0157
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
2ev.8/2/17
Name of person king statement
Personally Known OR Produced Identification
Type of Identification
Produced
Notary Public- State of
RACHEL
MISSOMY COMAlo I No.
EXPIRES Jan
_
ry 5, 2019
SUPERVISORI PLANS VEGETATION
REVIEW REVIEW REVIEW
REVIEW I REVIEW
RACHEL M DA
I
'= MY COMMISSION #FF1
7 1
9
ES January 5,
I 1fU'3t/Ee.c
m
REVIEW I REVIEW