HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t1
Date: 9/815 Permit Number: 1 SC6 CJ�� 1
RECEIVED SEP 0 S 1015
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 xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line�A
PRO.POSED;IMPROVEMENT.LOCATIO,N
Address: /�� `�.3
Legal Description:
Property Tax ID#: �D�—• �U �JZ ��� — OAU 3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK .
remove meter pedestal install 150 meter combo pack on 2" alum strut stand
CONSTRUCTIO411\1 FORMAT'10
N
Additional work to be nertormed under this permit—check all that appy:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
ZElectric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities:Sewer❑Septic Building Height:
OWN ER/LESSEE CONTRACTOR
Name 1' 4V, -e- 14- &K S, t' Name: John Law -
Address: /0.2 3 Alt HI r! Company: Law's Electrical Service Inc
City: _Tt to s-td, j3 r re--4X, _State: Address: 5158 NW Prim St
Zip Code: :?1-19S_-) Fax: City: Pt ST Lucie State:FI
Phone No. dZ 2 C,— 0-f `l Gi Zip Code: 34983 Fax:
E-Mail: Phone No. 370 4357
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: 29432
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
'SUPPLEMENTAL CONSTRUCTION:LI EN LAW INFORMATION.-
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
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.
a4e25�___ s
_Signature Owner/Lessee/Agent Signatur f Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -t-,-Jr.L.�c��'� COUNTY OF I?oL sc j 2
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ':�L day of 5-,t J20 Dby this 't day of 20 A5 by
�t��n v.�d► vJ �L��y\ l.,Q.�+J
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu lic-State of Florida) (Signature of Notary P blic-State of Florida)
J61VE
Personally Known OR Pro e¢1�€f�'c p a Personally Known O e Ide�O[K rw of Florida a`
Type of Identification Produ EPN s�aEe°� 6 2 Type of Identification Pr u4ei'6��% P°b' �`
ary P� rtes�� 10
a5916 P 5° fit, • .:MY Com E` H`
Commission No. l; ��°m`° � Z�yo�a�V „o' Commission No.
,Z• •i ZVI �°„�:�`�` Bondedtht
Ov
�i WSJ
Revised 07/15/2 14.. "``
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS