HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
H �[1�/' ([,{fig,•.���119°�lpyq I��fp�,
I{ tin -, j_ � Ci "��''EL"V, EC-✓�' 11
Building Permit Application MAR 2 E 2096
Planning and Development Services PER.'OI TMC
°°.
5UYUiUEiUH iiiViiivii ^t. Lucie County, FL 91
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential Wxx
PERMIT APPLICATION FOR: To Select from dro®box• click arrow at the end of line
a01 - IaC
Address:
Legal Description:
ce o
Property Tax ID#: 4-1 J-0;I - S61 1 - U 7 G(i fi -"s- Lot No.
Site Plan Name: Block No.
CII i •vt.-..�.��•.. - 1gg1g0
If Ce+��rbe crnn4 R�rlr• DOnh+Cirlo• t„co.C:d... 91
DETAILED DESCRIPl"ION OF lNORK
ai iasa�iv o �ro�si.i ".n..v..ii %1 moi. .. ..a.... .. .....E... .. •—ri: ...•b-..1 ..ice-.d CC -
..
-
nl. a a.aev:�a.a{,a as"_a en:aay.:aave—r-aat-ave wa�a�a•v- .. . - :-. - .. - - _ _. - _ - ie'a
ll_ Ad"ditional work to `e vel Orme under this oermit-c ec i a t at RODIV: _ 1_
LIHVAC L�1 Gas Tank ❑Gas PipingU_Shutters a Windows/Doors
ZElectric 0 Plumbing Sprinklers E Generator 1:1 Roof
eu si
Total Sq.Ft of Construction: sq.Ft.of First Floor:
Cost of Construction:$ 1,500.00 Utilities:U Sewer U Septic Building Height:
-
000NER/LESSEE ;. :r- CO,RITRACTOR
f� .( _ ..
a„ Narne I,er, \✓1 tM a'an �— J O4H t9YI✓1 k-e 1 Name JUHii 1\LpUY
�1I �t--- I lil
Address: f&cu Sh. Company: Law's Electrical Service Inc
City:41 ha V-0- a, Cr_ State:/Vm Address: 5158 NW Primm St
Zip Code: Fax: City: Pt St Lucie State:FL
991 'r-iii)iie leu. _7 /�1 .� Z �� OGE:
[ ( / � ✓L-( Lip L
9=9 E-mail: Phone No. WU4'S' I!
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
fiiGi 1 ie6
it If value of rnnctrurtinn is A?-;nn or mnrP-a REMRiSEr)ATntira of r'nmmPnr.Pmant is ronuirari_ �'
SUPPLEMENTAL-CONSTRUCTION LIEN LAIN 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 Owner/Lessee/Agent Signature f Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I l C Ir COUNTY OF /w/F-
The 2foing instrument was cknowledged before me The forgoing instrument was acknowledged before me
thisday of 20 J*by this-4 day of M f3er,9 ,20 1„4,_by
to HJ LOW
(N a of person acknowledgin ) (Na of person acknowledging
/r
(Signature of otaryPublic-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Prodgred Identification Personally Known OR Produced Identification
Type of Identification Produced D,L Type of Identification Produced . jq.Z-'
Commission No. ea A R E N S. N I E L S om fission No. ,
�YPY PYi, Rye
Commission N FF 11 637 .��et* �a�% KAREN S. NIEL �N
3. Commi
June 12, 2018 ,°;;'11t;;o� My Commission E' '09J
Revised 07/15/2014 June 12, 201 a
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS