HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: /�) ®3�
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
PROPOSED,IMPROVEMENT LO"CATION -
Address: -ex �(v�
Legal Description:
Property Tax ID#: L/S-G� _ S-D ) G�(v Uva, - 02 Lot No.
Site Plan Name: Block No.
Project,Name:
Setbacks Front Back: Right Side: Left Side:
DETAI"LED DESCRIPTION OF WORK
remove existing pedestal. install 150 amp meter combo on 2" strut stand
COhSTRUCTIONINFORM)AfION.
Additional work to e ertormed under this permit-1:1 c ec a appy:
HVAC Gas Tank ❑Gas.Piping _Shutters a Windows/Doors
Electric Plumbing Sprinklers E Generator 11 Roof
Total Sq. Ft of Construction: Sq.
of First Floor:
Cost of Construction:$ 1,500.00 Utilities:L_JSewer ElSeptic Building Height:
OWNER/LESSEE
CONTRACTOR:
Name fn 1G 114 r1 fit T, It kM C4 r Name: John R Law
Address: G (/-,.irr' K LAI Company: Law's Electrical Service Inc
City: SS.4� State: /V Y Address: 5158 NW Primm St
Zip Code: C Fax: City: Pt St Lucie State:FL
Phone No. /^ 7 9/- 1-1S y- 6 7 Y o Zip Code: 34983 Fax:
E-Mail: Phone No. 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:LA,W 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 ork or recording our Notice of Commencement.
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Signa tof Owner/ essee/Agent Signature of ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledgedbefore me
this -D, day of NOV 20 by this a),day of '>bV ,20 IS_ by
� L"o
(Name of person acknowledging) (Name of person acknowledging)
( nature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identificatio �Produ�cedCommission NoSea)), Commission No. LAS( INGRAM
_ *• « Notar Public-State of Florida
LASHAHNA INGRAM « *'=M
��• R`�c Not ;^. y Comm.Expires D
« s•;M arida oFF`o?:` ommission #FF 177249
Y Comm.Expires Dec 20,2018 """"�� Bonded through National Notary Assn.
Revised 07/15/ IAQ °'' Commission#FF 1772gg
"" • Bonded throw
REVIEWS FRONT ZONING SUPERV S PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS