HomeMy WebLinkAboutBUILDING PERMIT APPLICATION4
All APPLICABL INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 7 Permit Number: _
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"" Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Boa
1 PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION: I
Address:
Property Tax ID#: 7- 0'9 - 0/,As- OGO 3 Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Block No.
Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters -Windows/Doors
XElectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
o- d
Cost of Construction: $ A 000 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: -
CONTRACTOR:
Name 44s-7 d- lculd ac,Are &I a
Name- John Law
Address: 3/1 S 4N r vE L%i2
Company:Law's Electrical Service Inc.
City: Tvh n C oh 'Fnr�,i State: Z�&
Zip Code: I S !2 D Y Fax:
Phone No. /— /Y- A `-/ Z 7.2 kl-
Address:5158 NW Primm St
City: Fit 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-Maiijohrrdaw5158@aol.com
State or County License EC 13006370 29432
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is requaea.
If value of HVAC,is $7,S00 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
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LIEN LAIN' INFORMATION:
DESIGNER ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
City:
Zip: Phone
State:
Address:
City:
; Zip: Phone:
State:
_ ____
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Address:
City:
Name:
Address:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFROVIT: Application is hereby made to obtain a permit to do the work and installation as n Ica e .
I certify that no work or installation has commenced prior to the Issuance of a permit.
St. Lucie Counntfvl�make9 noyrepresentation that is granting a permit will authorize the permit holder to build the subject structure
which Is in
cture. Please consult withpyourHome Owners Associationandreview your deed for any restrictionsts may hicrestrict Y appl habit 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
commencin orK orrecoroingyour moucevt w,nn,cu,.=���_��.•
Signature oontrectorJticense Holder
Signatty� at Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing Instrument was acknowledged before me
this —7day of Tv)H 2O�by
thisdayof 7ul 20_2tby
i
1
Name of person making statement
Personal( Known — , �� OR Produced identification
Name of person milking statement
Personally Known 4/ OR Produced Identification
Type of Identification
Type of Identification
Producetd.
Produced
t !
bf Notary Public State of Florida )
(Signature of Notary Public State o
FtACHEL
DAVIS
No
Commission No. a- --)_ a!rf MY COMMISSIO
'na
FIACHELMDA
.•"
EXPIRES Janu
try 5, 20t9
[ ;• MY COMMISSION #FFt
(s0;) 3Y3dt 0 RxiUallota'YS
NIVO m
_ES January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION �0
REVIEW REVIEW RE E
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17