HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: Permit Number: I l oos�,
s
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 xxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROP-bSED�IMPR-OVEMENT,LOCATION
Address:
Legal Description:
Property Tax ID#: / --/I - C) "' U Uv ' 1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
-DETAILED OESCRiP.TION OF-WORK:-
remove existing pedestal. install 150 amp meter combo on 2"strut stand
CO.NSTRUCTION.]NFORMAT ION:
itiona workto bene orme under this permit—check a appy:
HVAC l_l Gas Tank ❑Gas Piping _Shutters n Windows/Doors
0 Electric 0 Plumbing Sprinklers F Generator R Roof
Total Sq.Ft of Construction: SCI.Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities:!��(Sewer Septic Building Height:
OWNER/I ESSEf: CONTRACTOR:
Name N?fv.;z k/r'Pt Name: John R Law
Address: ko Q 1-:1 ✓ Company: Law's Electrical Service Inc
City: W A z[2-� State: A/J Address: 5158 NW Primm St
Zip Code: 0 "7 7 3l7 Fax: City: Pt St Lucie State:FL
Phone No_ I- Cl ' LISA`'1 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
B value of construction is$2508 or more,a RECORDED Notice of commencement is required.
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SUPPLEMENTALCONSTRUCTION LIEN.LAWINFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 tender or an attorney before
commencing work or recording our Notice of Commencement.
ZL41� s
_Signatur f Owner/Lessee/Agent Signa a of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF � .� . COUNTYOF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
�
this day of•N,N 20 IS q `
by this
day of 334 .20 _1� by
U 01NN'� 1'� 7Dnsn LQ,,D
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-Stat f Florida)
Personally Known 4 oduced Identification Personally Known OR Produced Identification
Type of Identification dro quo"U. Type of Identification Produced
ASHAHNA IN6RA
Commission No. _•«
;mac Notary(pNp�yk_State of Florida Commission No.
MY Comm.Ex naY� •o,, ,
commission Dec 20,2018 '' • ," _9 a;AJota,v PukkSHAMAdNISSJ01
mission Fr ,,. Note_My Comm.Expires Dec Revised 07/15/2014Commission#FF 17
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS