HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO/ /z UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. / Permit Number:
•
Planning and Development Services
SuUding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34W
Phone:(772)462-1S53 Fax:(772)462-1578
Building Permit Application
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential xxr00000i
Address: l q 2- 1115- /f /zs
Property Tax ID #: 4i -�- O ;L - s-o 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:
_Mechanical _ Gas Tank _ Gas Piping —Shutters
Electric _Plumbing _Sprinklers —Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
w
Cost of Construction: $ GG o Utilities: —Sewer _Septic
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name L�%1,4Vi z,n 4-
Address: ,ix 3 i S'4 i3c ) (A r9
City: )2 t' State:,
Zip Code: 3 c/ 67 S 7 Fax:
Name -John Law
Company., Laws Eliectricai Service Inc.
Address:5158 NW F rimm St
City: Pt St Lucie State: P1
Phone No. % i21 - /Z 3 7 .S .Z C,7
E-Mail:
Zip Code: 34983 Fax:
Phone No 772 370 4367
E-Maillohnhm5158@201.com
State or County License EC 13006370 29432
Fill in fee simple Title Holder on next page ( M dliferent
from the Owner listed above)
If value of construction is $2SQ6 or more, a RECORDED Notice at commencement is required.
If value of HVAC Is $7,50D or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: — Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to ooram a permn LUUV L11= w,,, � el,u -••_.. __ ..._.____
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 conflict with any applicable Home Owners Association rules, bylaws or, and 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 1 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 ement
commencark or recoi din our Notice o ommenc
m
n
SIgnat0 of Owner/ Lessee/Contractor as Agent for Owner
Signature of ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY Of
COUNTY OF
The for °ing instrument was acknowledged before me
g`I
The forgoing instrument was acknowledged before me
tt by
�Vr c' , 2Q2l b
this � day of Y
this 1 day of Tv �+ e . 2qe
Name of person king statement
Personally Known IZ OR Produced Identification
Name of person m king statement
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
bf Notary Public- State of Florida)
(Signature'of Notary Public-Stateo
..` k
t� RACHEL
DAVIS
Commission No. �" V !` , , : " ' My COMMISSIO
I
NO 4
RACHEL M DA
EXPIRES Janu
ry 5. 2019
S.. 'P MY COMMISSION #FF1
I4071 MH 53 Roridallotary
rvmw'com
.,Mo,,.-,. ES January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION ROYEe.c
COUNTER REVIEW REVIEW
REVIEW
REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17