HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C7o Permit Number:
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) 452-1578 Commercial Residential xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of Eine
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
r"--?,J"I G .4v
Property Tax 1D #: >�- C' - U r — f� 1J Z_ ry - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
fLLH1VV't' I[ s'#G'`"� H '9.1-
�TsA,1( %tl-2c-i, m e 4'-r .5 o- Vi'_( [e, 4 -f -r
aaitionai worx to ne pefformea unser tnis permit — Ci
1 MVAC 1:1_ Gas Tank ❑Gas Piping
ZElectric ❑ Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $C' cl
inin aPpiY=
El- Shutters E(]]] Windows/Doors
DGenerator D Roof
S'Ft of First Floor: _
Utilities: U Sewer 1:1 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name. C: ) ,!iy�r' ;a �7�
Name: Jahn R Law
Address: 96,S S C= 1L1';V 4 1 4 If
Company: Law's Electrical service Inc
Address: 5958 NW Primm St
City: }°_{' S ( y6 rr State: t
Zip Code: tI 9 -7 Fax:
City: PT ST Lucie State: PL
Phone No. 2 U i - I i _U - _
Zip Code: 34983 Fax:
E -Mail:
Phone No. 772 374 4357
Fill in fee simple Title Holder on next page (if different
E -Mail: johniaw5958@aol.com
from the Owner listed above)
State or County License: 29432
It value of construction is $7.500 or more, a RECORDED Notice of Commencement is required.
-SU'PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: i Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
i Address:
City: State:
I city: State:
Zip: Phone:
Zip; Phone:
FEE SIMPLE TITLE FOLDER: _ 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 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 5t. 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.
S
Signature of caner/ Lessee/Agent Signature of Con ctor/License Holder
STATE OF FLORIDA I STATE OF FLORi A
COUNTY OF - . J Cle COUNTYO� Le)c f
,J)
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of20 Eby this day ofS 20 / by
P�-o uj/)
(Nam f person acknowledging) (Na e f person acknowledging)
S. wa_kry('�_ �(.�eklwl' WOL,
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida)
Personally Known � OR Produced Identification Personally Known OR Produced Identification
Type
of Identification Prolduced Type of Identification Pr duced
Commissi !~P i � (Seal) Commission Nar_iL (06 � (Seal)
ANNE BROWN WA '�'µYw i. ANNE BROyy
MY N WAA
%ar
COMMISSION # FF9W63 ' �' COMMISSION �!
,0f
14401
Devise . , 014EXPIRES FFl�i3q
n� 2i. 2020
(40 39"153 398.0153 FJIP 3 gprl! 21. 2020
N
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
4