HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: M., / Permit Number:
S - J
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 wxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: —I.0 7 S S� a c Y1 3 i C✓ —.._ _.
Legal Description:
Property Tax ID #: S / % o - 0 2, o -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
I CONSTRUCTION INFORMATION: III
VA"1C
rrv.n tiv a,c c���r��r�cu LIMA LIS i.ICIIIIIL-'LI
�HWAC _Gas Tank E]Gas Piping
LJ Electric ❑ Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
17 1
rr�r-
Shutters
E_ Generator
SFt. of First Floor: _
Utilities nSewer[]Septic
E]Windows/Doors
E] Roof
Building Height:
OWNER/LESSEE:
CONTRACTOR:.
Name . . 1Lw •. r p - /.r/f rC' g -rt _^
Address:—/ k. t + - L, "a V r -
City: G l 1-r.- State: 011
Zip Code; L OL ! CI Fax:
Phone No. ! .7 (� ( L_(3 `l
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: John R Law
Company: Law's Electrical Service Inc
Address: 0108 NW Primm St
City: PT ST Lucie State: FL
Zip Code: 34983 Fax:
Phone No. 772 370 4357
E -Mail: johnlaw5158@aol.com
State or County License: 29432
it value of cunsErucuon is �Pisuu or more, 2 KtLuKuku Notice of Commencement is required.
SUPPLEMENTAL. CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
IMORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: i Not Applicable BONDING COMPANY: Not Applicable
Name: Name.
Address: I 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
commencin work r recording our Notice of Commencement•
S
_ Signature of ner/ Lessee/Agent Signator f Contractor/License Holder
STATE OF FLORIDA. 1 ,STATE OF FLORID
COUNTY OF
_2W' d. onJ COUNTY OF
The forgoing inst^arae t was acl�nowledged afore me The forgoing instrument was acknowledged before me
this day
of 2 by I this d y of 0C_-7L 201b by
Aj(p I
(Ntffie of person acknowledging ) I (Name of acknowledging)
person
7:tgnature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida I
Personally Known - 'Y� OR Produced Identification Personally Known OR produced Identification it
Type of identification Produced Type of Identification Produced
o.5
Commis s o;tif4i~ v'"C'r eal Commission No. ....... (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIONSEA TURTLE � MANGROVE
COUNTERREVIEW REVIEW REVIEVii RE-VIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS