HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEWED
Building Permit Application MAR 2 8 201
Planning and Development Services PERFAIT 1NG
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x)P «
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPRQUEMENTatO"CATION
Address: /U 7A r S- GCt-t-1 OSI fs+ ' �6
Legal Description:
Property Tax ID#: To l UU q.2 - VCJ c' - U Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
remove existing pedestal. install 150 amp meter combo on 2"strut stand
CONSTRUCTIONr IN;FORMATl
Additionalwork toe ertormed under thiT thispermit–c ec a appy:
HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
�✓ Electric 0 Plumbing Sprinklers ElGenerator E]Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities: Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTOR _
Name 14oi-4,J d- /1'4v4c.Z GN Name John RLaw
Address: A '14,S-S C EQ J A, Company: Law's Electrical Service Inc
City: loS G- State: Address: 5158 NW Primm St
Zip Code: 3 419 9 3 Fax: City: Pt St Lucie State:FL
Phone No. 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 C0N'S TRiUCTION 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 to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
_Signof Owner/Lessee/Agent Signature of Co actor/License Holder
STATat OF FLORIDAS ' . STATE OF FLORIDA
COUNTY OF o 1�C,L�� COUNTY OF I
The forgoing instrument wa acknowledged before me The for oing instrument wa acknowledged before me
this day of 20 Ila by this day ofMiq20 f�by
l.� � h� Ln
(Name'-df person acknowledging) (Name of person acknowledging)
r.•
(Signature of Notary Public-`State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification t/ Personally Known OR Produ ed Identification V
Type of Identification Produced FL Type of Identification Produced L
ion No. / � Seal
Commission No. 15 so,n.P al) KAREN S. NIELS I S�-�
?,
"I Commission # FF 1 15637 hA
=�. '7= My Commi.
June 12, 2018Commission# FF 115637
Revised 07/15/2014 ? My Commissi
on Expires
oF+ Exit
June 12, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW - REVIEW
DATE
COMPLETE
INITIALS