HomeMy WebLinkAboutBUILDIONG PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a �1` a 2 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxxxxxx
PERMIT TYPE
PROPOSED IMPROVEMENT LOCATION:
Address: Z Q 2-kr i OC "4h oft #
Property Tax ID #: / 11S-// - 5101 - 0 / 6 VOO - mot No.
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
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:
w
Cost of Construction: $ ai O Cl
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name N,n CArA0 /3.-vd.. t.r. O Tir
Name:John Law
Address: / 0 7,2 S So 0C rdAl 10R 1X 1-/ 9
Company: Laws Electrical Service Inc.
Address:5158 NW Primm St
City: .f a *1 s ir" Y7 r it e C State:
Zip Code: 3 `1 9 S 7 Fax:
Phone No. 1 -7 S %' G 2 i - SS O.J?'
City: Pt St Lucie State: Fl
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-Mail)ohniaw5158@aol.com
State or County License EC 13006370 29432
if value of construction Is $2500 at more, a RECORDED Notice of Commencement is required.
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:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address'
Zip Phone:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFF(DVIT: Application is hereby made to obtain a perms TO au cne wu, R a,N ,,,�-,.a.,-•• - -- --
i certify that no work or installation has commenced prior to the Issuance of a permit.
St. Lucie County makes no repre ttaatian that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applica a Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult w7th 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 !will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lurie 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 Retard a Notice of Commencement may resuk in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobs1 e
before the first Inspection. If you intend to obtain financing, consult with lender or an attomey before
....—.nnnAna wnrl• nr ratnMino vnur Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTY Of
The fo oing instrurn�,�gt s acknowledged before me
this day of r-� 2032by
Name of person milking statement
Personally Known OR Produced Identification
Type of identification
Produced
t
(Signature of Notary Public- State o
�A "' 1t RACHEL
Commission No. n-
fi"� _ My COMMISSI
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EXPIRES Jar
REVIEWS
Rev, 8/2/27
Signature
STATE OF FLORIDA
COUNTY OF
The forgoing instru nt was acknowledged before me
this2lday of 7e S . 2022bY
Name of person r9 king statement
Personally Known OR Produced identification
Type of Identification
Produced----
Notary
DAVIS
No. ' ; -ate
y 5, tots "4 RACHEL M
•1 MYCOMMISSION
FRONT I ZONING SUPERVISOR I PLANS I VEGETATION
COUNTER REVIEW REVIEW I REVIEW I REVIEW