HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
3}JBE C_ J� z 03
Building Permit Application PEAR 2 8 2016
Planning and Development Services PERMH-711�
Building and Code Regulation Division St. Lucie Cauni y. -: L.
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED JMPROUEMENT LOCATION
Address: 1()-7;2S- S O C 'e 4 H a Pt
Legal Description:
Property Tax ID#: SUJ— u/J2- Ovo - 7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF WORK
remove existing pedestal. install 150 amp meter combo on 2"strut stand
CQNSTRUCTION W,FORMATION y
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dACIditional work toene orme under this permit-c ec al appy:
b
HVAC E]Gas Tank ❑Gas Piping _Shutters a Windows/Doors
�✓ Electric 0 Plumbing Sprinklers E Generator 1:1 Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities:0 Sewer E]Septic Building Height:
.OWNER/LESSEE 4 � = CONTRACTOR
Name _14-cop Vr,-<<N e- Pah r7n Name: John R Law
Address: 3 '-1,C/v L44 Company: Law's Electrical Service Inc
City: Ov I,4vi.I v State: Address: 5158 NW Primm St
Zip Code: Fax: City: Pt St Lucie State:FL
Phone No. AA cl 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 NIP km
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.
d4�1ems s
_Signatu of Owner/Lessee/Agent Signature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF I—w,f r'
The fo oing instrument was acknowledged before me The for oing instrument as acknowledged before me
this day of �(n _, 20 Lby this o� day of 20 by
JAIL I in�V'J Wi
(Na a of person ack wledging) (Name of person acknowledging)
q ,
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Proceed Identification
Type of Identification Produced VZ 0.1-. Type of Identification Produced i` L, /--)4L,
Commission No. (Seal) Commission No.Go 1,5(DS-7Seal
KAREN S. NIEL EN +""""; KAREN S. NIELSEN
PY Py , .�';F"Y°"9r''•, It FF 1156371
Commission It FF 11
Revised 07/15/2014 ° My Commission Expires - _ My Commission Expfires i
� June 12, 2018 ,,;FOF June 12, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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