HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: v 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 xxxxxxxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: -S _f .L / V e f7 /Trr Is /V.v
Property Tax ID #: 4-1 SO 2- - So 1 - O S'1 k U O i/ -
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit -check ail 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:
v Utilities: Sewer
Cost of Construction: $ — — Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name F
Name:John Law
Address: /0S'3 NofP/t, 971-Z
Company: Law's Electrical Service Inc.
Address:5158 NW Primm St
City: T-C - s r IS f � � 1, State:
Zip Code: 2 Y 9 S-7 Fax:
City: Pt St Lucie State: FI
Phone No. 77.- - 3 'rr
Zip Code: 34983 Fax:
E-Mail:
Phone No 772 370 4357
Fill In fee simple Title Holder on next page ( If different
E-Mailjohnlaw5158@aol.com
State or County License EC 13006370 29432
from the Owner listed above)
If value of construction Is $2500 or more, a REeoRDEO Notice or t.ommencemeni ,a ,culLi
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
_ Not
MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Zip:
_Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK ano mscauanon as InmCa IBU.
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 az 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
o 0
L- r recordin our Notice of Commencement
commen,
Signat of Owner/ Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this V day of G C. %- 20 'Wby this .2� day of &C •� 203Q by
Name of person m king statement Name of person making statement
Personally Known _ OR Produced Identification Personally Known _� OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public- State o of Notary Public State of Florida I
�M,"• w RACHEL DAVIS _
Commission Na. 4 G \ i » � a1w MY COMMISSIO PrR�fff31 No. f ` a Ve ,.
dF" EXPIRES Janu ry 5. 2019 :+: `"k:.. RACHEL M DAI
"�""•''' '- MY COMMISSION #FFli
1407)76i-O 8 Flondamtary nice. com
•,, o, w,. ES --January 5,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION NQVEe.c
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
Rev.8/2/17