HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 JA I Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxxxxxx
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: �� /1/v ///+J a/ i,-/
Property Tax ID #: ySO a - s'o I - l o ! l " G U 6 - f Lot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter PENAW 0 CG v&--1 L. d
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: Sq. Ft. of First Floor: _
Cost of Construction: $ J ,2 SU _ Utilities: _Sewer _Septic
Building Height:
OWNERXESSEE:
CONTRACTOR:
Name /% A- lM,l�.. y6L
Name:John Law
J
Address: 9o"t - /t/,cf//-r4 a/yr/
Company:Law's Electrical Service Inc.
City: +L� car, ✓2r .o-c A State: .6�
Zip Code: 3 `19 S'7 Fax:
Phone No. SS-7 - 7 l G U
Address:5158 NW Primm St
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-Maiijohnlaw5l58@aol.com
State or County License EC 13006370 29432
if value of construction is $2500 or more, a RECORDED Notice of commencement ,s 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
Name:
hAriracc-
City: state: _
Zip; Phone:
BONDING COMPANY: _,Not Applicable
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is nereoy mace to oowrn a N=r nn•
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
strruicctture. Please co sult withyour Home Owners Owners Assoc
nd reviewyyour laws deed focovenants
any res�Mcctions whi restrict
applyhihlt 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
commencingeork or recorcling your Notice of Lornrnw
L.W1I rcu L. R
/.ter
Signature of ontractor/License Holder
Signat4A of 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
7� zO�Jby
this Z_ day of -T�j.y 2Q,-t by
this day of 1� _�
I
Name of person making statement
Name of person making statement
Personalty Known OR Produced Identification
Personals Known % OR Produced Identification
Personally
,
Type Identification
of Identification
Produced
Produced
t ,
�-
bf Notary Public- State of Florida)
(Signature of Notary Public 5tate o
r
RACHEL IY
DAVIS a
=
Commission No. + =`l a MY coMMissl
�/
No x FlACHEL M DA
1
EXPIRES Janui
try 5, 2019 MY COMMISSION #FFt
�`•
(aa;)3N9-b153 P,ariJaNataNS
rri,:e.cam iM'
M r S January 5,
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION GV6
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17