HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � �1 Permit Number:
RECEIVED
O
Building Permit Application DEC /4 2015
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 1MPROUEMENT LOCATION
Address: .S' S 66e4A art, k4 S`3b
Legal Description:
Property Tax ID#: /- j;-o 2 - GG C"?- Ci o v 6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
QETAILED,DESCRIPTION OF WORK r
remove existing pedestal. install 150 amp meter combo on 2"strut stand
CONSTRUCTION INFORMATION
Additional work to flGasTank
orme un er t is permit c ec a appy:HVAC Gas Piping OGenerator
Shutters Windows Doors
R]Electric0 Plumbing Sprinklers Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities:Sewer F]Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name y von Irr r.-., /9 A,., Name: John R Law
Address: v?,� a S Company: Law's Electrical Service Inc
City: Pi.µ i S� hA. 1 State:qt- Address: 5158 NW Primm St
Zip Code: 6 Fax: City: Pt St Lucie State:FL
Phone No. .1.2`I 9L,2 S`'f 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
I f value 0f 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 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 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 tender or an attorney before
commencing work or recording our Notice of Commencement.
s
_Signatur of Owner/Lessee/Agent Signature Contra or/License Holder
STATE OF FLORIDA V - STATE OF FLORIDA
COUNTY OF COUNTY OF
The for oin Inst ent was acknowledged
The forgoing instru ent was acknowledged bef I; ged befog
this day of �G 20 �b a *" this 7 day of�C C , ,20
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(Name of person acknowledging) Q X<�~ (Name of person acknowledging) j Cy
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(Signatureo otary Public-State of lorida) mT i (Signature of No Public-State f F orida m 8 `
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Personally Known X OR Produced Identities V Personally Known OR Produced Iden kation
Type of Identification Produced " N Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS