HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/10/15 Permit Number: � d�"��4
L�IAWCAS _ RECEIVED
Building Permit Application AUG 1 2015
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie Count; L
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential xxxxxxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
4
PROPOSED IMPROVEMENT LOCATION, '
Address: 10725 S OCEAN DR 455
Legal Description: HOLIDAY OUT AT ST LUCIE-SEC B BLK O LOT 1 AND EQUAL PRO-RATA INTEREST IN COMMON ELEMENTS(OR 3681-2657)
Property Tax ID#: 4511-502-0071-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF WORK
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remove existing pedestal. install 150 amp meter combo pack on 2" strut stand
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CONSTRUCTIOAdclN INFORMATION
.:. . 2 itlona wor to "a e ormeunder
un er t Is permit-check a appy:
aHVAC E]Gas Tank ❑Gas Piping Shutters Q Windows/Doors
ZElectric 0 Plumbing Sprinklers 1-1 Generator F] Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities: Sewer ElSeptic Building Height:
NEA/LESSEE CONTRACTOR -
Name William T Rogers Diane L Rogers Name: John law
Address: 10725 S Ocean Dr Lot 455 Company: laws electrical service inc
City: Jensen Beach, State: Fl Address: 5158 nw primm st
Zip Code: 34957 Fax: City: pt st lucie State:fl
Phone No. 229 2926 Zip Code: 34983 Fax:
E-Mail: Phone No. '7_2e2 27c, ' 7
Fill in fee simple Title Holder on next page(if different E-Mail: johnlaw5158@aol.com
from the Owner listed above) State or County License: 25284
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION;LIEN LAIN INF`ORMATI'ON h
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE-COMPANY: _Not Applicable
Name: Name:
Address: Address:
--y - - - - - - -- - -— -- ---
: - ----- - State: -- ---_- City: Mate:
Zip: Phone: Zip: Phone:
_FEE SIMPLE TITLE HOLDER: . .Not Applicable BONDING COMPANY_: Not Applicable__ -
:Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 will authorize.the permit holder to build the subject structure
which is in conflict with any applicable 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
commencing work or recording our Notice of Commencement.
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- -_Signatur of Owner/Lessee/Agent-- - - - --- - -Signature.of Ctractor/License_Holder
STATE OF FLORID STATE OF FLORIDA
-__ COUNTY OF J� COUNTY OF-
STATE
F S�1
The forgoing1fis ment was acknowledge efore me The forgoing instrument was acknowledged
J)efore me
this L day of20 by this 1� day o .20 �� by
(N of person acknowledging) (Na of person acknowledging)
_/Ngnatl6re of Notary Publff-StaA of Florida). gnat a of Notary Public- ate . ,Florida)
Personally Known OR Produced-Identification Personally Known - OR-Produced Identification. -
Type of Identification Produced Type of Identification Pr, uced
-- AHNA INGRAM
--, a ., — - AS � -
Commission No. .:���►+;, Commission No. ,•`� YP 4'-,,_ I
HNA'�I CNAM �. Nogr lic-State of Florida
Notary Public-State of Florida My Dorm.Expires Dec 20,2018
CommIssInA #FF 177249
• Bonded through Nation�:,Notary Assn
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Revised 07/15/20 %F°FFA°a�', Commission # FF 17724':
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE -
INITIALS