HomeMy WebLinkAboutBuilding Permit Application (2)ALL APPLICABLE NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l 4� Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Fierce FL 34982
Phone: (772) 452-1553 Fax: (772) 462-1578 Commercial Residential xxx ooc
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 61), S A/C /-/ 1-f /?/t.-
Legal
?/�
Legal Description:
Property Tax 1D #:
Site Plan Name:
Project Name: —
Setbacks Front
-S-U-;2- - SCJ } - OS-/ / - 0 u U
Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No._
Block No.
remove existing pedestal install new 150 amp meter combo pack on 2" alum strut stand
Haamonai worx to ne pertormecl unper this permit- check allapply:
M
HVAC 11 Gas Tank []Gas Piping _ Shutters Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 0 Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ �ip J0 `- Utilities Ft
11 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name (!,%I- � _(_ o ; a- 4 -7d.
c�
Name: John R Law
Address: 6�),r arc
Company: Law's Electrical Service Inc
City: ,I e e'?s r ., State: i ff
Zip Code: __I L ";7 S % Fax: �
Phone No.�.Cl am/- J (
Address. 5158 NW Primm St
City: PT ST Lucie State: FL
Zip Code: 34983 Fax:
Phone No_ 772 370 4357
E -Mail: T
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
E -Mail: johniaw5l58@aol.com
State or County License: 29432
it value OT construction is �Pzsuu or more, a RECaRDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION LIEN LAT INFORMATION:
Name: _
Address:
City;
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name: _
Address:
City:
Zip:
Phone:
Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
State:
Not Applicable
Address:
City: State:
Zip= Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip' Phone:
Not Applicable
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 1 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_
_ Signature r Owner/ Lessee/Agent
STATE F FLORIDA
COUNTY OF
The fokgoing instru t was ackn wiedgel pefore me
this T� day of S' 2l) by
(Name of person acknowledging)
6, L La LW
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Ede '
ANNE BROWN WALMACH
My COMMSSION 41i 663
EXPIRES April 21, 2020
Revised 07/15/2014
Signature Contractor /License Holder
STATE OF FLORIDA
COUNTYOF L
The for oing MnA
iedge before me
this - day of Zl] �� by
(Name person acknowledging )
(Signature of Notary) Public -state of Florida)
P
Personally Known l' OR Produced Identification
Type of Identification Produced
Commission No_ �~--
t' _ ANNE[
WALMACH
rRg7 �4�`3 My COMMISSION # FF9Ma3
REVIEWS FRONT ZONING SUPERVISOR PLANS
DATE COUNTER REVIEW REVIEW REVIEW
COMPLETE
INITIALS
EGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW