HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ Permit Number: _
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34M
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential xxxxxxxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: / 0 7 a .�- S 0 C r4 in rJ /L /4=7 lb--�5
Property Tax ID #: Z-/s // +- .SD / - G ✓.3 `-/ — G 610 S-�' Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Block No.
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. FL of First Floor:
Cost of Construction: $ 41 .20G, Utilities: _Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name
Name: John Law
Company.Law's Electticel Service Inc.
Address:5158 NW Pnmm St
Address: 01 Nt 'c k ?V -4 11*a 0f
City: 1zroo {—.- Pc'.1 State: !Lr
Zip Code: O to 90 `i Fax:
Phone No. 7 % 2 - 2 'A- °7 - 2 GSA
City: Pt St Lucie State:F1
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail)ohnkm5158@aoi.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 $2SW or more, a RECORDED Notice of Commencement Is required.
If value of HVAC is $7,S00 or more, a RECORDED Notice of Commencement Is required.
I 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
Address:
City,
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby mane to obtain a permic co uu o,e w a „a.•- • -- •••- -- --
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. Plea a consult any applicable
owners Association andrreviebylaws
your deed for any estr ctionmay
wh which restrict
y aprohibit 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
commencin OrK or reL;uiumis VUU1 ivuutc u, wnun=
Signa 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
�v c 20 2i by
this ! Fday of -3 n C 202! by
this 1 day of
Name of person making statement
Personally Known OR Produced Identification
Name of person Viking statement
Personally Known OR Produced Identification
Type of Identification
Type of identification
Produced
Produced
-�Y
f Notary Public State of Florida j
{Signature of Notary Public State o
"" RACHEL
DAVIS
Commission No. '�: `r . '>.?'` ad. 3 My cOMMissio
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No
�`�_ RACHEL M DA1
EXPIRES Janu
ry 5, 2019
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t January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION SW°
REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17