HomeMy WebLinkAbout458 holiday out permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: yh4lAl Permit Number:
5-- ` `J 'c
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 xxxxxroa
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: /U 9AJ- S 06 r,Au? Y,7a j5 ys�
Property Tax ID #: y .i//- $�U .Z - 0 0 7 4E - GGv - ! 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:
Block No.
_Mechanical
_ Gas Tank
_ Gas Piping
_ Shutters
-Windows/Doors
_ Electric
_ Plumbing
_ Sprinklers
_ Generator
—Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ C)
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name T_ vcal4r d-Y��.ead
Address: /& 72.1- S,ycflyh 0#1 1 'I.SV'
City: "'Sevrr-r.ro Y2V'? L, State:%/
Zip Code: 3 'it; r 7 Fax:
Name:JohnLaw
Company -Laws Electrical Service Inc.
Address:5158 NW Primm St
City: Pt St Lucie State: F�
Phone No. l- `lI4l - r'I6 7 - 0,7, 6 0
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail:
Fill in fee simple Tilde Holder on next page ( if different
from the Owner listed above)
E-Mailjohniaw5158@aol.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 HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Address:
City: State:
Zip; Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
Zip; Phone:
OWNER/ CONTRACTOR AFFILM i s Application Is nereoy mace w -a,,, a F=...... •� - - - -
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co3ict with any applicable Home Owners Association rules, bylaws or ano covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin ork or recording our INouce ui lAliinncrn
c:..=..
Signature of ontractor/Li ense Holder
SignatyY of Owner/ Lessee/Contr�s Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The f'or$oing instrument was acknowledged acknowledged before me
The forgoing instrument was knowledged before me
day 21 a eby
this ir day of �. 20 a (by
this of
Name of person Lon�aking statement
Personally Known � OR Produced Identification
Name of person in king statement
Personally Known OR Produced Identification
-
Type of Identification
Type of Identification
Produced
Produced
ey-s'
�)2, 1
Notary Pue of Florida
f blic Stat)
(Signature of Notary Public- State o
RACHEL
DAVIS
Commission Na. E \ i ?3 a. ; MYCOMMISSIO
rP i
No. V � >
RACHEL M DA
EXPIRES Janu
ry 5, 2079COMMISSION
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ES January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
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VEGETATION WEe.
REVIEW REVIEW REVIE
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/Z/17