HomeMy WebLinkAbout148 holiday permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: st / Permit Number:
Planning ona uevelopmenr �ervlces
Building and Code Regulation Division
23001Rrginio Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Building Permit Application
Commercial Residential *DD20 oc
Address: /G 7:L S' S OC t-4 " 107 1IZ- 4�c / t d
Property Tax lD #: 47r/ l
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:
_ Gas Piping
_ Sprinklers
—Shutters
_ Generator
Sq. Ft. of First Floor:
Lot No.
al..rl. Ain
windows/Doors
Roof Pitch
Cost of Construction: $ IRC'U v Utilities: Sewer _Septic Building Height:
owNERAESSEE•
CONTRACTOR.
Name 4 L 65i
Name: J111L
Laws
Company:l-e1"f's Electrical Service Inc.
_ __Lr
Address: 7 A 3 CJ 4 J o�, S t
C �I State: H'1
City: �i 6 ll va
Zip Code: 4Y r Uf/ / Fax:
LucrC: nl 77a- 014 `i ;z `l.2 6
, �
Address:51r'8 NW Pdmm St
City. Pt St Lucie State: F�
Tin Cede 34983 Fax:
(Phone No 772 370 4357
i Mail
E-Mail:
Fill in flee simple Title Holder on next page ( If different
from the Owner listed above)
E-Maili0hniaw5168@a0l.com
I State or County License EC 130106370 29432
_s.. _ _a __ _ __ I_ s+annn _ � vY,nveis._ n _ ..,...,• �,,.r... .� . �...
if value of HVAC is $7.00 or more, 3 RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION. i
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is nereny mace to oocain a N., -• •- - --- —
I certify that no work or installation has commenced prior to the issuance of a permit.
st. Lucie Count makes no representation that is granting a permit will authorize the ermit holder to build the subject strt%cture
structure. Please co sult anyapplicable
Home Owners Association and review your deed for any restrictions which may apply iblt 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
ork or recordingour nonce or �ommencri
r ...
7commencin
1Y
Signature of ontractor/License Hoider
Slgnat 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 #grgoing instrument was acknowledged before me
o� oday /Vav . 20 gf by
this �- day of A/o (/ , 20 2�1 by
this of
Name of person making statement
Personally Known OR Produced Identification
Name of P erson m kin statement
Personally Known_OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
bf Notary Public State of Florida
(Signature of Notary Public State o
CHEL(d;'
DAVIS
Commission No. `V V a , . ap° MY COMMISS)O
NO.
JPl�PIW pp RACH£L M DA
i
EXPIRES Janu
ry 5, 2019 : •_• MY COMMISSION #FF1
µw) M-0153 FloridzNciary
rvice.C"m of 7 [ ES January 5,
w.✓'
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION AYEe.
REVIEW REVIEW REVIEW
COUNTER REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17