HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
ti IJ _
7114' AM
i
Planning and Development Services
Building and code Regulation Division
2300 Virginia Avenue, fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit Application
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential xxxxxxxx
Address: 2 U G 7 /V t CI 1` i/
Property Tax ID tt: y S" C)., - S'U / — U U ? U G a G - ;2.— Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Ronlace FYistinn Meter nedestal
Block No.
I CONSTRICTION INFORMATION; 1
Additional work to be performed under this permit- check all that apply:
_Mechanical
A Electric
_ Gas Tank
Total Sq. Ft of Construction:
Plumbing
Cost of Construction: $ 70 o
_ Gas Piping
Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE;
CONTRACTOR:
Name fh �1 'ez d- S t " e./i*r ii "%_
Name: John Law
y
Address: II 2 M/m V t
Company,Law's Electrical Service Inc.
25- O
City: /floc„ n y fl& -I, State: �
Zip Code: A,? (;.a S Fax:
Phone No. /' 7 0`(' 70 fo 4/ 9 o O
Address:5158 NW Primm St
City: Pt St Lucie State: Fl
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-Mailjohniaw5158@aol.com
State or County License EC 13006370 29432
If value of construction is 5z5oo or more, a nti-unutu nonce al UUFFIUICu4.i,nO1• — , may,..• -•
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUGTfON 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 Applicable
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao the worK ano Ia Scaud UUn dd IIIV ILd
I 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, wails, 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
..I- _ -- A;— r KL.tb•u _f ('nm manromcnt
LUII If I MI ILIII UIK UI ICLUI U $I le YWUI I
------
51gnat 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
for)?
this— 20_ by
this day of J—+e 20 -Iby
Name of person Taking statement
Known OR Produced Identification
Name of person king statement
Personally Known person
Produced Identification
Personally _
Type of Identification
Type of Identification
Produced
Produced
~~'
�
(Signature of Notary Public- State o
fNotary Public State of Florida I
RACHEL N
DAVIS
F -,x
241
Commission No.
My COMMISSIO
flollWgl
No. i
?
•.; rq EXPIRES Janu
ry 5, 2019
RACHEL M DAN
_
(407}M)f] tI 3 FloridallotarYS
IVICe.CORI
MY COMMISSION #FFii
•. -,EXI
TffES January 5,
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
OVEe.o
REVIEW
REVIEW
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17