HomeMy WebLinkAboutBuilding permit appAll APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: o ? Permit Number:
ijll
• 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 xxxxxmxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 6 % 6 N6 /f /rs /lI L, -o'
Property Tax ID p: yso &0 9- 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:
Sq. Ft. of First Floor:
Cost of Construction: $ � 0�-G U , - Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name M14,r-E 6arntom:✓)0
Name: John Law
company:LaWs Electrical Service Inc.
Address:5158 NW Primm St
Address: 6 / f, Nz #Ir.r Al.,-'
City: << 12eg State: r'/
Zip Code: .3 I/ S S J Fax:
Phone No. % - % 3 a' 6 la- 3 9 / `/
City; Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail lohnlaw5158@aol.com
State or County License EC 13006370 29432
If value of construction is $2500 or more, a RECORDED Notice of commencemem is requneu.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
[SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Gririracc
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Address:
City:
Zip: Phone:
Name:_
Address:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inoicatea.
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 andcovenantsthat 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
mmencinwork or recordina your Notice of Commencement.
c o
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 day of G G �- , 20�r/by this �e day of OGi' . 20�?Q by
Name of person m king statement Name of person king statement
Personally Known person
Produced Identification Personally Known rr OR Produced Identification
Type of Identification Type of Identification
Produced \ Produced
iSignature of Notary Public- State o bf Notary Public State of Florida
y"" `" • RACHEL DAVIS _
Commission NO. � `'- � "> �� a 1 MYCOMMISSIO yAwo No. \ '� +" '°°q;.
•.'.o,;, nd,,• EXPIRES Janu ry 5, 2019 ,+.' - RACHEL M DQ\
""-••--' _" MY COMMISSION#FFil
p07) 3N80153 Flondallotary rvice.com 't
. e!o ,+' j S January 5,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION I 91'JUEe.c
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
Rev.8/2/17