HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO/MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:// �/ Permit Number:
i
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxm
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: /0 %,Z �- ` e- 4 k,
Legal Description:
Property Tax ID #: �l S //- .-a ,� " C� YO 7 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:
aHVAC E] GasTank E]Gas Piping fnShutters Q Windows/Doors
ZElectric 11 Plumbing 0 Sprinklers E Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $
S Ft. of First Floor:
Utilities: 11 ElSeptic Building Height:
OWNER/LESSEE:
Name /ZA-e.-/ a'- Oc,,,44 14 4..,,.,
i V
Address: /Zi, I/ /-o�•IG
City: /3,7,4, //G State:
Zip Code: 0-5_ 3 �f C) Fax:
Phone No. _21
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 State: FL
Zip Code: 34983 Fax:
Phone No. 772 370 4357
E -Mail: johniaw5l58@aol.com
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: Applicable
Name:
_Not
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 thepermit 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.
Inconsideration 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 FLORIDA
COUNTY OF <4 / 001e
Theforgping instru nt was acknowledge before me
this 3! day of 1X4 U.Sf 20 by
V
n n� Ar-ogyn 10mcc h
(Nam of person acknowledging)
''W &JW_ (k, IO&C-4
(5i Notary
Public- Stae of Florida )
(Signature of
Personally Known �L— OR Produced Identification
Type of Identificatio Produced
NE BR� WALMACH
Commission No. COMMI SIO # FF9e4663
: EXPIRES April 21. 2020
1487) ,,153 PWkWNamrySsmc0.c0m
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
Signature Contractor ense Holder
STATE OF FLORID ZvC/�
COUNTY OF
The forgoing instrArent was acknowledged before me
this 3/ day of _LGLS/,S,;L . 20 lk_ by
�nnc iirn 1 � lolinco chi
(Na f person acknowledging )
(Signature of Notary Public- State of Florida )
Personally Known_ OR Produced Identification
Type of Identification Produced
Commission No.4' ,
ANIWB�OWN WALMACH
MY COMMISSION # FF.
EXPIRES April 21. 2020
59
1447) 39"1
FfO1d'Nft"ervica.com
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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