HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
t.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential W00:0oc
PERMIT TYPE:
I PROPOSED IMPROVEMENT LOCATION: I
Address:
C-
Property Tax ID fl: y-S 0 a— .510 1— O 72 U- G 0 p- 1 Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical
Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ / 07 0U
_ Gas Piping
_ Sprinklers
Block No.
Shutters -Windows/Doors
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:John Law
Address: '/�4-" /Ire/
company:Law's Electrical Service Inc.
Address: 5158 NW Primm St
City; Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
City: TC17f-ca Jlr.r-C-4 State:[—[
Zip Code: 3 f-/ I J- 7 Fax:
Phone No. /- & 3 / - .2 7 - 71/A I
E-Mail:
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Mailjohnlaw5158@aol.com
State or County License EC 13006370 29432
if value of construction Is $2SDD or more, a RECORDED Notice or Commencemem is requwrea.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Not
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Addi
City:
Zip:•
Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
ArlrirPcc-
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK and in5tauation ab niun.dieu.
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 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
k d' our Notice of Commencement
commencln or or recor In ny
i
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 0 day of 0 C IL 20Jjby
this 2jQ day of OG I 203Q 6y
Name of person m king statement
Known OR Produced Identification
Name of person king statement
Personally Known person
Produced Identification
Personally _
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State o
Notary Public State of Florida )
t_ RACHEL
DAVIS
_
Commission No. S- \.> ?�
MY Commisslop
d,
EXPIRES Janu
1(407)
fiplQf@'f13310
try 5. 2019
Na E`<
y " w�c,:, RACHEL M DAN
WS-0157 Floridallotary
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;y.. 1 MY COMMISSION #FFII
ES January 5.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
ROVEe.c
REVIEW
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17