HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABL INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: oZ Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Building Permit Application
Commercial Residential M000O0i
Address: 9 LL A/ e /J /v .-/
Property Tax ID #: O O i U a-2 0- 0 0 0 Z `� Lot No.
Block No.
Site Plan Name:
Proiect Name:
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
cost of Construction: $
AZ.) UU ��
_ Gas Piping
_ Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors
_ Roof Pitch
Utilities: _Sewer _Septic Building Height:
/
OWNER/LESSEE:
CONTRACTOR:
NameF., l I Si.-? c S L L_ C_
Name:John Law
Company: Law's Electrical Service Inc.
Address: 8 `/ c/S' E 4-C Lvh C . 'r
Address:5158 NW Primm St
L 1 State: LC.
City: r+ c ri w
Zip Code: Fax:
City: Pt St Lucie State: FI
Phone No. I- tic/ a - 7 3 O - 3,?a16
Zip Code: 34983 Fax:
Phone No 772 370 4357
E-Mail:
E-Maillohnlaw515B@aol.com
Fill In fee simple Title Holder on next page ( If different
State or County License EC 13006370 29432
from the Owner listed above)
i 1 ed
If value of construction Is $2500 or more, a RECORDED Notice of Commencement s requ r
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone
State:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as inoicaiea.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no represenrttation that Is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with an dpplicaCle 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
COmmenFIn U!K Ur rCLU1U11fX VUU1 I\Vul.c VI �.vnn ncr
n.c
Sl�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
20,p_, ( by
this _ day of 20_ by
this gL_� day of �6 k5
Name of person making statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known = OR Produced Identification
T1
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public State o
bf Notary PublicState of Florida
RACHEL
DAVIS
Commission No. 1, ': a r My coMMissici
s?f
fYMplit;lo
2019
No.
l RACHEL M DA
EXPIRES Janu
ry 5,
t�.a''
IV'�? MY COMMISSION r
i+on 79NS-01 7 FlorldallotaryS
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1 ES January5,
5,
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
PLANS
REVIEW
VEGETATION "0
REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17