HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
" °" I Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xb00000c
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION: i
Address:
e lY / fJ
Property Tax ID #: Z-15—r SO J — D 00�"A.a G'UU c/ Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Existing Meter pedestal
Block No.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit— check all that apply:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
r✓
Cost of Construction: $ i GU
_ Gas Piping
Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name 1-e-v� a-i".f, Lz I�*�,r.(,'ol
Name: John Law
Address: G .?7 /V e Hke-r 11
Company, Laws Electrical Service Inc.
Address:5158 NW Primm St
City: _ -T-r ri f-r a 13-r4 0 4, State:
Zip Code: 3 '-/ % S I Fax;
Phone No. l' %c-lS" k7-7— S `i U 9
City: Pt St Lucie State: FI
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Malllohnlaw5t58@aol.com
State or County License EC 13006370 29432
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
_ Not Applicable
State:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Appiication is hereby made to obtain a permit to do the work
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in con ict 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 lender or an attorney before
.. �,_ _ .._.._ w,—.I-- _t t•............ro mant
commencin OrK or recorum uui NOE—u, wnuno,�=.�••.•
••
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 forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
�dayof _--
this! `tdayof 74j.� c 202r by
this I e 20211 by
Name of person making statement
Personally Known _ OR Produced identification
Name of person Taking statement
Personally Known OR Produced Identification
Type of identification
Type of Identification
Produced
Produced
off—
f Notary Public State of Florida)
(Signature of Notary Public State
RACHEL h
I DAVIS
)i
Commission No. S Z ;5 k a MY COMMISsto
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ippit8 3l
No. '
`, RACHEL M DA1
' EXPIRES Janu
lry 5. 2019
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- € MY COMMISSION#FFli
9J9-0153 RondallotarySi
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ES January 5.
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17