HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MAST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��� Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia avenue, Fort Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 462-1578 Commercial Residential xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: c: _e2
Legal Description:
Property Tax ID #: LIS -1 0 q f o'(iC' r t Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
remove existing pedestal install new 150 amp meter combo pack on 2" alum strut stand
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit— check all apply:
HVAC _ Gas Tank Gas Piping _5hutters Windows/floors
ZElectric ElPlumbing ❑Sprinklers ElGenerator 0 Roof
Total 5q. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ i ( Co 6) , Utilities: Sewer [leptic Building Height:
OWNER/LESSEE:'vs'�v+P�---s
Name 1,f
Address: J / // +� fv r ° G res fn ��
. City: L V r% '� �? 6✓ '� State: /lr'r
_ Zip Code: Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: John R Law
Company: Law's Electrical Service Inc
Address: 5158 NW Primm St
City: PT ST Lucie
Zip Code: 34983 Fax:
Phone No. 772 370 4357
E -Mail: johnlaw5158@aol.com
State or County License: 29432
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FL
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:
J Address:
City:
city:
Zip: Phone:
Zip: Phone: —
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 Horne 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 your Notice of Commencement.
Signature of O er/ Lessee/Agent
STATE OF FLORID -
COUNTY OF � f1 _ le
Theforg ing instru nt was acknowledge before me
this Pday of 1/, S-,,- , 20 12by
— LLE ArQ/J,0 ,mac
(Nam of person acknowledging)
'W&dW— � l��
(Signature of Notary Public- State of Florida
)
Personally Known_ OR Produced Identification
Type of Identificatio Produced
Commission No. NE BIZ WALMACH
CflMhlI SIGN # FF984663
��IEQA�� EXPIRES APM 21, 2020
(407j38Y•O153 FWrkUN*WrySWVjW.C=
Revised 07/15/2014
SignatureContractor/License Holder
STATE OF FLORIDA-/ / d Ci e
COUNTY OF �i�� iL,
The forgoing instr en w3ss acknowledged before me
this 3/ day of U' l 7' .20 � by
�nn(L tk 1011)96
(Na f person acknowledging )
it/U
&""'
(Signature of Notary Public- State of Florida)
Personally Known OR Produced Identification
Type of Identification Produced
Commission No, ' AN
OWN WALMACH
My COMMISSION # FF484gal
EXPIRES April 21. 2020
F 4407j tW FbrWaNb
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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COMPLETE
INITIALS I I