HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S. 7 Permit Number:
• Building pp Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772)462-15S9 Fax: (772)462-1578 Commercial Residential XKX0°o'x
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: Gl 7 I // G ///r1 Y.f l v J
Property Tax ID Ii: YS 0 g ` S0 / - / / Sk - O U U — Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace E:xiating 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:
V"
Cost of Construction: $ 0 U c)
—Gas Piping
—Sprinklers
Shutters
Generator
Sq. Ft. of First Floor: _
Utilities: —Sewer _Septic
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name 3.tc-t% d- rzL 1-1 .. P"u.. r n
Name:3ohn Low
Company,Law's Eledrical Service Inc.
Address:5158 NW Primm St
Address: .20W E MA/n Sy-
City: (' 41 e cczo k r',0 State: N9;t
Zip Code:g 7 3 / b Fax:
Phone No- l - 6 !b IY S-0 - 9 c7 y 3
City: Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Maillohniawbt 58@aol.com
E-Mail:
Fill in fee simple Title Holder on next page ( H dWerent
from the Owner listed above)
State or County License EC; 13006370 29432
if value of construction Is $25W or more, a RECORDED Notice of Commencement is requwrea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
[SUPPLEMENTALCONSTRUCTIQN 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 AFFIDVIT: Application is hereby mane to omam a perms to uu u,= a1,u -• • --... ----.
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
structure. Please cconisult any applicaHome ble
Owners Assoc atlon Association
drreview your deed or covenants
restrictions o thats wh which may al. prohibit such
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
f C cement
our Notice o omen
commencin rk or orecordingm
s
Signature of ontractor/License Holder
Signats of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
20_g_( by
The forgoing instrument was acknowledged before me
this ] Z day of 0`114&,� 20_;4 by
th is 1Z day of _� 49
Name of person ipaking statement
Personally Known R Produced Identification
Name of person making statement
Personally Known `OR Produced Identification
_
Type of identification
Type of Identification
Produced
Produced
r i
w
f Notary Public State of Florida
(Signature of Notary Public State o
€RACHEL
DAVIS
,�
Commission No, r F C �'� , , z MY COMMISSIO
No. RACHEL M DA
9,tc
EXPIRES Janu
ry 5. 2019
My COMMISSION #FFi
(e07) 3908 53 Flondallotary,
'Nice.cam
`w+'• '
,, a• ,.S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION 9VEe.°
REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17