HomeMy WebLinkAboutBuilding PermitAll APPLICABL5 INf O MUST 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, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxXXXXxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: ski 09-6o Ale- /-Z(?-1 /,?/V-1 -
Property Tax ID #: y S`0 a - --C0 / " GO J� % " oc-,c -' Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Existing Meter pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Block No.
_Mechanical
_ Gas Tank
_ Gas Piping
_ Shutters
-Windows/Doors
_ Electric
_ Plumbing
_ Sprinklers
_ Generator
—Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ G✓U c/
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNERf LESSEE:
CONTRACTOR:
Name Ht"nc Nti d Y/r.hr C +rvr
Name:John Law
Address: -`/ R r yr .Sf
City: S H& State: Ly�
Zip Code: Fax:
Phone No. -C,-f 6
Company-Law's Electrical Service Inc.
Address:5158 NW Primm St
City: Pt St Lucie State: A
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Maili0"a"5158@a07.c0m
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 $2500 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.
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 made to obtain a permit to oo the wul �•--•--
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countt�, makes no representation that is granting a permit will authorize the hermit holder to build the subject structure
structure Pleasetco sult wl thpyour Home Owners Association andrreview your deed for any restt5rict that
which maor
alprohibit 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
commenan OUK Or reLUIU111 UUl IVUl14C U 1 �.n, a 11
„1 ........
Signat . 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 sing instrument was acknowledged before me
The for�oing instrument was acknowledged before me
�dayof Tv� c 2D�t by
this I rdayof TVr c 202 by
this 1
Name of person making statement
Personally Known "ZOR Produced Identification
Name of person m king statement
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
of Notary Public State of Florida )
(Signature of Notary Public State o
RACHELN
DAVIS
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11�I
Commission No. 1 :> % zi MY COMMISSIO
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No a . a
RACHEL M DAy
ta��t EXPIRES Janu
ry 5, 2019
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S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION e.c
REVIEW REVIEWE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17