HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .Z Permit Number:
I�j- J;
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential 7 XxXXX7 x
PERMIT TYPE:
I PROPOSED IMPROVEMENT LOCATION: I
Address:
Property Tax ID #: !�e S CE- ~ - s'U / — G 15 7 - o G o E'
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work lobe performed under this permit -check all that apply:
Mechanical
"'Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
v
Cost of Construction: $ '� 0 f"0
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Sq, Ft. of First Floor: _
Utilities: _Sewer _Septic
Lot No.
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name cr . Ld Z )"cIech f fi � ,- _
Name:1o1n Law
Address:2 q 1�2 S--4✓ 14f S CA— ✓C ✓
Company: Laws Electrical Service Inc.
Address:5158 NW Primm St
City: F,4 State:
LA
Zip Code: `J 37 Fax:
City: Pt St Lucie State: F1
Phone No. 3A
Zip Code: 34983 Fax:
E-Mail:
Phone No 772 370 4367
Fill in fee simple Title Holder on next page (if different
E-Mailioiinlaw5i58@aol.com
from the Owner listed above)
State or County License EC 13006370 29432
If value of construction is $2500 or more, a RECORDED Notice of commencement is requoea.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW !NFOFWATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: -
City: State:
Zip: Phone
Name:
Address:
City. State
Zip: Phone: —
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Name:
Address:
City:
City.
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT.' Application is hereby madeto obtain a permit to do the wall. «n , .�-••o-•-• • — - --
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 wild outharize the permtt holder to bufld the subject structure
which ie m conflict with arty applicable Home Owners Assoc+attar rules, 6Yfaws ar ana covenants that may restrict ar prohibit such
structure. Please consult w h your Home Owners Assodatton and review your deed for arty restrictions which may apk
in consideration of the granting of this requested permit, i do hereby agree that !will, in ail respects, perform the work
in accordance with the approved plans, the Florida Building Lades and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full wncurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non resident al use
ce for
WARNING TO OWNER Yaur failure to Retard a Notice of Commencement may result in your paying twi
improvements to your property. A Notice of Commencement must be recorded and posted an the Jobs;te
before the first inspection. if you intend to obtain financing, consuft with lender or an attorney before
..
as Agent for Owner I Signature
STATE OF FLORIDA
COUNTY OF
The forgoing Instrument was acknowledged before me
this I day of F'r /} 20- 2by
Name of person mpking statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State o
commission No. 3-
r
i!,`'
'c,?a
(a67) 3
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
r
STATE OF FLORIDA
COUNTY OF
The fo oIng instrurpnt yeas acknowledged before me
this day otf" 6 .20L.Iby
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
RACHEL 114 DAVIS
MY COMMISSIO PR93" No.
EXPIRES Janu4iry 5. 2018
SUPERVISOR I PLANS I VEGETATION
REVIEW REVIEW REVIEW
RACHEL M
MY COMMISSION