HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S c Permit Number:
G --
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 54982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Building Permit Application
Commercial Residential )O O
Address: / U 7 2 1- S D -r Q-� YJ ✓L -rte ty
Property Tax ID #: -moo �t, - G U _7k- 0 UG - 7 Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
cl-
Cost of Construction: $
_ Gas Piping
_ Sprinklers
Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: _ Sewer _ Septic
OWNER/LESSEE: CONTRACTOR:
Name d- C- J e - Sc,"A ., l 1411
Address: 06c'.4— /4'/'C7
City: /i ✓_o r �� f!7 c Se -YI- State: A_/J
Zip Code:C" 7 7 / 7 Fax:
Phone No. ! - �✓ Z -1 1 `l
E -Mail:
Fill in fee simple Title Holder on next page 4 If different
from the Owner listed above)
Block No.
Windows/Doors
Roof Pitch
Building Height:
Name:John Law
Company: Lavv's Electrical Service Inc.
Address: 5158 NW PnMm St
City: Pt St Lucie State: F1
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mailjohnlaw5 t 58�aol.aom
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 HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
7:51
Address:
City:
Zip: Phone
State:
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 instaiiation as Indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counmakes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conty ict 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
�ingyork or recorcling your Notice or LommencemenL.
of Owner/ Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of{'r1� 20 --AC by
Name of person m king statement
Personally Known OR Produced Identification
Type of Identification
Produced
of Notary Public -
Commission No. V4 F \4i1 35\
KI
REVIEWS I FRONTZONING
COUNTER REVIEW
Rev. 8/2/17
STATE OF FLORIDA
COUNTY OF
The forgoing of was acknowledged before me
this—day of 1_' ti 20 6 by
Name of personking statement
Personally Known _ R Produced Identification
Type of Identification
Produced
Notary Public- State of
RACHEL DAVIS
MY COMMISSIO kPfRgif3310 No.
EXPIRES Janu ry 5, 2019
SUPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW
REVIEW I REVIEW
kg% RACHEL M DA
If
• MY COMMISSION #FFI
7:51
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S January 5,
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REVIEW I REVIEW