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HomeMy WebLinkAboutBuilding Permit Application S ALL APPLICABLY INF7/10 UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ) f Date: 14 Permit Number: I l 0 © � dill IVED Building Permit Application MAR 2 8 2016 Planning and Development Services Building and Code Regulation Division PERE:WTING 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select fr T dropbox, click arrow at the end of line PROPOSED INIPROI%EMENT„LO:CATIQN a ,C Address: 10 7 S` S- Gct h r,, Legal Description: Property Tax ID#: 1-4 S l _ SU 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 CONSTRUCTION INFORMATION ACIditional work toe nerformed under this permit—check a app y: HVAC 1:1 Gas Tank Gas Piping _Shutters (�Windows Doors — ❑ g L_1 Windows/ Doors Electric 0 Plumbing Sprinklers ❑Generator ❑Roof Total Sq.Ft of Construction: Ft.of First Floor: Cost of Construction:$ 1.500.00 Utilities Sewer❑Septic Building Height: OWNER/LESSEE CONTRACTOR .._F. Name 049c,vi d� G✓r%lura �i�l�i+���.. Name John R Law Address: 1 7 U 1 Company: Law's Electrical Service Inc City: WI Urge 1 Stater Address: 5158 NW Primm St Zip Code: Fax: City: Pt St LucieState:FL Phone No. 1 7 U— `, Cv— `�Q Dov 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 to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement. s _Signature of caner/Lessee/Agent Signature of ontractor/License Holder r STATE OF FLORIDASTATE OF FLORIDA COUNTY OF _ 1J L'I I� COUNTY OF_ / • L11 C�.t�: The forgoing instrument was cknowledged before me The forgoing instrument wa acknowledged before me this day of�la V[1� . 20 L(�by this day of y 1, 20 _V0 by (Name of person acknowledging) (Name person acknowledging) f V - 1 (Signat re of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known ersonally Known OR Produced Identification Type of Identification Pro c�e1�h� L• [K�-( E•N S. N I E L S E N ype of Identification Produced 04 =� Commission 8 FF 115637 Commission No. = N mission Expires '° �5�1�' Commission No. q``( #ARE a 12, 2018 2NF - omm!s os NIELSEI Y Common: 'CF17 S, Une ]2 2p'8 fres Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS