HomeMy WebLinkAbout471 holiday out permitAll APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 al Permit Number:
Building Permit Application
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Building and Code Regulation Division
2300 Virg info Avenue, Fort Pierce FL 34982 Residential )OODOOCXx
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT TYPE:
' PROPOSED IMPROVEMENT LOCATION:
Address: 7.aS S Oc e 4in Orb .a 9 7
Property Tax ID #: Uf �/ ! - S o bL� �0 & 1 -Gov - _ Lot No.
Site Nian Name: -
Project Name., _
DETAILED DESCRIPTION OF WORK:
Replace Existing Meter pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
Mechanical
VMElectric
_ Gas Tank
Plumbing
_ Gas Piping
_ Sprinklers
—Shutters
_ Generator
Windows/Doors
— Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
O�
Cost of Construction: cf Utilities: _Sewer _Septic Building Height:
OWNERAESSEE• CONTRACTOR: I
r.. I - _ 1� / .. ._ - i as m�•_i+uu _axv
Address: /07AS S aceavr 0-ft # iyol
City: rry3sr., llsr4t ry l-, State: Fr♦
Zip Code: 319S2 Fax:
i
E-Mail:
Fill In fee simple Title Molder on next page (if different
from the owner listed above)
Company:Law's Electrical Service Inc.
Address:5158 NW Primm St
City. Pt St Lucie State: FI
?in Code: 34983
772 370 4357
Phone
Fax:
E-Mail70hnlaw5158QaoLcom
State or County License EC 13006370 29432
0 val.._ _r wn;;.ruy::r;; t,ena �..rr., a frnQnfn Nntirp of ccement is 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 TIRE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: City: State:
Zip: Phone:
BONDING COMPANY: _Not
Name:
Address:
City:
Zip: Phone:
._.� __A ac indirated.
OWNER/ CONTRACTOR AFFIOVIT: Application Is nereoy mane to vuLam a r�„• . _ -• •- --- ---
I certify that no work or installation has commenced prior to the issuance of a permit.
St. L cie Counttyy makes no represenrttation that is granting a permit will authorize the ermit holder to build the subject structure
which is in con#lict with any appRtable Home Owners Association rules, bylaws or andpcovenants 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 worst
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 tender or an attorney before
rnmmencine work or recording your Notice of Commencement.
STATE OF FLORIDA
COUNTY OF
The forging instrument was acknowledged before me
this = day of Qc-f 20SAtt by
Name of person making statement
Personally Known — OR Produced identification
Type of Identification
Produced
Commission No.'t \ - i a. ' My COMMISSI
c?ar EXPIRES Jai
REVIEWS I FRONT COUNTER I REVIEW SUPERVISOR(ZONING REVIEW
Rev.
STATE OF FLORIDA
COUNTY OF
The for Ing instrument` a acknowledgbefore me
this lfydayof O
Name of person making statement
Personally Known OR Produced identification
Type of Identification
Produced
— r
Notary Publii
fitil3l No ' .>
RACHEL M
a, tote �� �•:
MY COMMISSION
PLANS I VEGETATION BMp
REVIEW REVIEW REVIEW