HomeMy WebLinkAboutBuilding permit app (2)All APPLICA8LE I F WIT BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I OBI Permit Number:
COUNTY Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34M
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxxxxxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address:
el IT I rf f.S i v
Property Tax ID9: '"!r 4i.r0,:). - s-O /- l S !.,S-- DCVO - C"�
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _Plumbing _Sprinklers _Generator TRoof Pitch
Total Sq. Ft of Construction: Sq. FL of First Floor:
G�
Cost of Construction: $ 1 (' c (0_ Utilities: _ Sewer _ Septic Building Height:
OWNERAESS£E:
CONTRACTOR:
Name C 4 ./ 1- tov w 1 1C _
Name:John Law
Address: r' 9 12 LOA— � f ,4 w c
Company:LaWs Ekertrical Service Inc.
1 / 'S State: #44
Address 5f58 NW Primm St
City: ys
� q.h
Zip Code: U Z (o_ oj. Fax:
arty: Pt St Lucie State: PI
Phone No.
Zip Code:34983 Fax:
Phone No 772 370 4367
E-Maillohnlav6158@aol.com
E-Mail:
Fill In fee simple Title Holder on next page (lit different
State or County License EC 13006370 29432
from the Owner listed above)
if value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
if value of HVAC is $7,5W or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: f
MORTGAGE COMPANY: _ Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a perms to oo cna w� R <„u , �, •••� --•--
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes noyrepresentation that is granting a permit will authorize the permit holder to build the subject structure
stru ture. Please consult wlthpyourHlome OwnOwners
rs Association and review your deed for any estrictions which maor
apply 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
commencing,IVOrK or reCUIL11118 Yuu1 lYUuLc up • U" „o
n ....
Signat of owneV Lessee/Contractor Agent for Owner
Signature of o t actor/License Hold
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
-7
this t `Fday of 7V, c- 20&1 by
this 1 !fday cf . 5- , 20� i by
Name of person % Fking statement
Produced Identification
Name of person making statement
Personally Known OR Produced Identification
Personally Known ,OR
I
Type of Identification
Type of Identifications
Produced
Produced
bf Notary Public State of Florida }
(Signature of Notary Public State o
RACHEL
M DAVIS
NO
Commission No. C- \ :>_'� , a ' MY COMMlssto
§i°
._RACHEL M DA
•"„+ro, EXPIRES Janu
ry 5, 2019
:
r . MY COMMISSION #FF7
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S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION RQWEe.°
REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17