HomeMy WebLinkAboutBuilding Permit Application ALL.APPL'ICABLE INFO MUST'.1BEC61MP1ETE0 FOR APPLICATION To.9E ACCEPTED
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Date: ? 1 G. Permit.Number:
�.. RECEIV7D JUL 12 7.016
B.u: ldi igPermit Application_
Planning&rid Deveiopment`Seriiices
Building and'Code-Regulatian:Drvision -
2300 Virginia;Avenue Fort Pierce FL 34982
Phone.(772)462=1553 Fax.(772)4624578 Cotnmercial: ReMdentia(
PERMIT APPLICATION FOR: P
To Select from dro box click arrow at the end of line 1 c >�
PROP05EpiIMPrROVEIVIENT LOCATION,
. ._ -
Address: j CJ 7 ( S a,e, e ii-w. E2 �7. _1 _
Legal Description:
'
PropertyTax iD#
��<< eG Sr. U(,:j Z, GGG U. Lot No..
Site Plan Name: 914ckNo.
:Project Name;.
Setbacks. 'Front Back R•ightSide:: teft,Side;=_
DETAILEDDESCRIPTIONOF
w
remove existing pedestal install_ new'1.50 amp riefer"combo pack on 2"strut stand:
CONSTRUGTIONSfiNFOIMATfON
f ,
'Additional,Work.to be pertormed, under thisl thispermit–c ec a l Apply
HVAC U Gas Tank FIGas Piping Strutters a Windbws/Doors
FA Electric 'Plumbing []Sprinklers. El
Generator Roof
Total Sq.Ft of Construction: $ .Ft of First Floor
nn .
Cost of Corstruction: �'. Utilities: _Sewer Septic Building Height:
OWNER%LESSEE' ° f4 ,t ACTOR tf
4 S i 4
S C M 1
ONTR
Name. rrrrV Si t(- Name. John,R Law
: I r7 ? 'Wi-''n s �u Law s.Electrical.Service Inc;
Address
S! Company:
.City: P S� State:a Address:.:5158',NW.Primm Si
Zip Code 3 9.r 7 Faz. City; k'Sf Lucie State:FL
Phone No.— a°1 33 Zip Code:34983' Fax:
E-Mail: Phone No..;370 4357
Fiifirilee simple Title Holder on'nextpage(.'if diffe"rent E`=Mail..lohniaw5158@aot`com
trom`the'owner listed above). State or°County License: 29432
If valueof construction is$3500 or more,a RECORDED,Notite;of Commencement is required.
:y tY
V o 1 C .4 #.,� 7 M1 N L r` t$ '§ 5 3 F�"a n,
SUppLEMN7 `L2CONS7`R�lCffO�N LttV LA1NE'iNFO1ViA�ION�� '` �� ,
.'n'��..,.,..: ,. .�`..tir�ii.'t ., ,
DESIGNERJENtaINEER; Not Applicable MORTGAGECOMPANYt Not Applicable
Name:. Name: —
Address; Address:. .
City., State: ityj, State::
Zipo Phone: Zip:- Phone:
FEE SIMPLE TITLE HOLDER.:; _Not Applicable BONDING COMPANY:. Not Applicable
Name:. Name:. _-
Address: Addressc_
-City.-
zip: Phone. Zip:, Phone ....
I ceMNLthat nc(work:,or:installation has commenced priorto the,issuance of-a per
St,Lucie County"makes no,repiesentation.that is"granting•a permit wi ll.a Uth o 626thep'eir'mit holder to build.the sutiject structure.
which is'in conflict with any applicable Home Owners Association rules,'bylaws or'and.covenants'that;may.eestrict:or prohibit,such
structure.Please_consult.with your Home.Owriers;Association and;revieia your deed for any restrictions which may apply:
In consideration'of the granting of this.reguestedpermit,-I do;Fiereby,agree that l`.will,'in all respects,perform the work
in accordance with the approved plans;the Florida Building Codes arid--gt.Lucie County Amendments
The following buildiifg,petmitiapplications are e-xempt from undecgomg a"fu11 con currency.review:,ibb- additions,
accessory structures;swimming pools;fences,walls;signs;screen rooms and accessoryuses to another non residential use';
WARNING TO OWNER:Your failure:to Record a'Notice of Commencement"may resultin your paying twice
;for
irripcovementsto your property A Notice of Commencement must be recorded and postedon-the jobtite
pefore thefirst inspection. If you intend to obtain financing,con"suit With lenderor an attorney.before:
commenCiL ng work or recordingyour Notice C-6mmencement.
S
Signature -.Ownec%lessee%Agent: Signature o ontractor/License Holder
STATE OF FLORID /
LSTATE OF,FLORI
COUNTY,OF.:.i ., 47 .,.... COUNTY OF f•%�CJC.Ie,
The for ging instrument -as`acknowledged before_me The for omg instruument was.acknowledged before me
tFiis day of. 20 �by this' day of- 1y/�� 20 ! b
_ �� Y
.(Name of person acknowledging,) (Na of pe san racknowledg ng)s
( ignatue of Notary Public-State of Florida 1, (Signa.ture of Notary Public-State of F orida,}
Personally Known OR,Produce&Identification persona Ily'Known bk Produced Identification
Type of Identification Poduced _ 'Type of Identification Produced` -
Commission No:, e A OWN WA
7 ( WACN
Why 'i.MY MmitSION,#FF.04063
st ..
_:air ocPIRIsr1I 21:aI120
6INY2t2Q2o +or saaa,a3
Revised 07/1512014,
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