HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ! Permit Number: _
,COUNTY ' Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XXKXX xx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 1.17 -3 /yG 77 l't-r IT
Property Tax ID fi: 4y Sr os2 - S—D l — -s6 a — oot�, — l
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 Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
cr
Cost of Construction: $ G U Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name a l
Address: (22 Sarur_� ttvv 12c!
City: I/lid & 61 ✓ P l I State: Jig-
Zip Cade: / 7 ,f'Y !o Fax:
Phone No. 1 - r 7 d 3.3Co - 73 cj !Z
Name:John Law
Com pa ny: LaWs Electrical Service Inc.
Address:5158 NW Primm St
City; Pt St Lune State: Fl
Zip Code: 34983 Fax:
Phone No 772 370 4367
E-Mail:
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Malljohniaw5158@aol.com
State or County License EC 11006370 21432
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.
[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 AFFIDVfT: Application is hereby mane to oatam a permit to QU U:r m �: w a„� �•a•• -- •••-•-- --
1 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
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 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 tender or an attorney before
commencan orK Or reWFUIII UUl IYUtILC u, run unto
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77
TignatuX 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
Aday -ry c 20a 1 by
this ` day of 7u� c. , 20�l by
this I of ✓+
Name of person making statement
Personally Known i—loz 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 j
(Signature of Notary Public State o
p`M RACHEL
DJNVIS
Commission No. � V 1 , _t `'t *air!! MY COMMSSS10
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No. ' '' ,r a".
RACHEL M DA
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aw EXPIRES Janu
ry 5, 2019
COMMISSION &FF73U
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S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION0WEec
REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17