HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/28/15 Permit Number:
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
PROPOSED IMPROVEMENT LOCATION -
Address: /o 7A S" I GC e g,.- On
Legal Description:
Property Tax ID#: 1—/S J 1 -SG J G��g 4-/ -Grid ' 1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF,WORK:-,,,,-:
remo existing pedestal. install 150 amp meter combo on 2" alum strut stand
CONSTRUCTIONINFORMATION s
itiona wor to e e orme under this permit-check a appy:
1jHVAC 13 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric F]Plumbing Sprinklers 1-1 Generator a Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities:0 Sewer r]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name nylory N Name: John Law
Address: k L A cwc Company: Law's Electrical Service Inc
City: M e--)vc S c. State: W l)- . Address: 5158 NW Primm St
Zip Code: Fax: City: Pt St Lucie State:FL
Phone No. Zip Code: 34983 Fax: '
E-Mail: Phone No. 772 370 4357
Fill in fee simple Title Holder on next page(if different E-Mail: johniaw5158@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 LIEN 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 thepermit 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.
S
_Signat a of Owner/Lessee/Agent Signature of Conti or/License Holder
STAT OF FLORIDA STATE OF FLORIDA
COUNTY OF -. X10_ COUNTYOF
The forgoing instrument was acknowledged-before me The forgoing instrument was acknowledged 40ore me
thA day of SQ 201 by thi!�X day of 20 J by
(Name of person acknowledging) (Name of person acknowledging)
ign ture of Notary Publi State of Florida) Signature of Notary Public- e of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. .NP.i+„a tNGR tor+ a LASHAHNA INGRAM I�
Stat of F I) Commi�slo�o, �tclto of Florida l)
pubii� Der
20.20 v,
Expires �2Agu+•_My Comm.Expires Dec 20,2018
° mmiss�on Notary PS 9. 4�
Re , d.07/15/201hroug Bonded through National Notary Assn.
hNaGonal �.1 ',,,,�,���,,,•.
REWEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS