HomeMy WebLinkAboutBuilding Permit Application Y
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: / /. Permit Number:
RECEIVE®
Building Permit Application DEC
Planning and Development Services /4 2015
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential ?xxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION
Address: 11 ,5-7 /V r Hfr-3
Legal Description:
Property Tax ID#:_ rd.Z .-d 1 1 3 `I U 0 U- l Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRLPTION OF WORK,
remove existing pedestal. install 150 amp meter combo on 2"strut stand
'CONSTRUCTION lNFORMAT.IO ,
N.-
Additionalwork<to
e ..e_ red . ._..:. s
me under t is permrt-c ec a appy:
HVAC 11 Gas Tank ❑Gas Pi MGenerator
Shutters QWindows/Doors
PingR✓ Electric 0 Plumbing []Sprinklers Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities: Sewer O Septic Building Height:
OWNER/LESSEE. � ," _ " `:� CONTRACTOR _
Name IV i'clI wt.,It Name: John R Law
Address: Ao g.,X- S"1 S2 Company: Law's Electrical Service Inc
City: m ool,& v, f i a State:AVL Address: 5158 NW Primm St
Zip Code: Fax: City: Pt St Lucie State:FL
Phone No. I ' 7 O°'l- yUA - C A2 & 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 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 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 t ain financing,consult with lender or an attorney before
commencingwork or recordingour ,4p Commencement.
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_Signature of O ner/Lessee/Agent 2Signature Contractor/License Holder ;th<Yy
V2i-
m-<STATE OF FLORIDm�m STATE OF FLORID
COUNTY OFN�m COUNTYOF F
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The fo oing instr ent was acknowledge b �ed�e= The Zfing instr ent was acknowledge 01M,this day of 20 o p m thisday ofg2c` 20co UM
4ame of personc owledging) (Name of person acknowledging) ^'
aoh� A-37 �� xv.
(Signature of Notary Public-State of Florida) (Signature of Not Pubes-State of Florida)
Personally Known XOR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced 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