HomeMy WebLinkAbout479 holiday outAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -5117 /P, / Permit Number:
CJNTY
• ' Building Permit Application
Planning and Development Services
Suiiding 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: lO 7,9 S S. 0<r n v, fit 4E$7 y % 9 r�
Property Tax ID 4: Lf S/l - .SO X - D G 3 1 - C/o O — 6 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:
r G�
Cost of Construction: $ d GU
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name &.1 Id 4 '7g-n. #- Gv.'rr,'e.t
Name: John Law
Address:-9 j 6 rn cvh uri'd 1 Ori,
City: A� , if - h_ State: r'/
Zip Code: .7Fax:
Phone No. 71;t.. %a r7 X�l 2,&
Company,Law's Electrical Service Inc.
Address:5158 NW Primm St
any: Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Maillohniew5158@aol.com
E-Mail:
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above)
State or County License EC 13006370 29432
If value of construction is $25M 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.
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Address:
City -
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and Installation as indicated.
I certify that no work or installation has commenced Prior to the issuance of a permit.
St. Lucie CounttFlyy makes noyreprese tation that is granting a permit will authorize the permit holder to build the subject structure
strlucture. Pleaseccwith onsult wlthpyourrHiorne Owners Associationtandrreview your de a for any restantsrictions tions wh ch maor
applyhibit such
In consideration of the granting of this requested permit, I d° 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
commencing,worK or recurum Vu1 IVVULput wn u1icn..v,1
.qq
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i
Af/
Signat' of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontrador/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 J 7 day of —kI,,' 4 20_2_(by
this la day of T 20,4 by
Name of person making statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known fir` OR Produced Identification
_1.Z
Type of Identification
Type of Identification
Produced
Produced
of Notary Public State of Florida)
(Signature of Notary Public State o
RACHEL
DAVIS
Commission No. `s` S �'`---_>'`, i MY COMMlSSIO
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RACHEL M OA
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ry 5, 201971
_ ! MY COMM:SStON #FF9
(401)3894i153 Fluritlra allory
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.tmwF, S January 5.
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION YEa.
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17