HomeMy WebLinkAboutBuilding Permit Application.SUPPLEMENTAL ONSTRUCTION LIEN LAW NFORMATION:
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:
Andress:
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
commencing work or recording; vour Notice of Commencement.
�:Z�_Sig ture of Owner/ LesAgent
SPATE OF FLOR�� f � C 1 �
COUNTY OF _ h
The f"2ping instrument was acknowledged fore me
this — day of —T— A 20 acknowledged
(Name of person acknowledging)
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(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of identification Produced
FP�'gk4(o63
Commi ion ,ANN BReWN WALIAN
*: MY COMMISSION # FF9M63
'•.,,a EXAIRES April 21, 2020
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REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
Signatur/ofera- License Holder
STATET
COUNTY OF �yCC ,,/ UC
Thefo oing instr , } u-�-nt was acknowledged before me
this T day of an , 20 / 1by
�, 0 /9d ", (� Tl..l
(Name of person acknowledging)
0,1-0 Brown ma.hv Gtt
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission -No. FE 4 N In6,3 (Seal)
ANNE 8ROW&WA6Wt i
MY COMMISSION11 FF984663
,.,..�� EXPIRES April 21, 2020
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SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / / �. ? / 1 % Permit Number:
- +J.
Building Permit Application
Planning and Development Services
Suilding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 452-1553 Fax: (772) 452-1578
Commercial Residential xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of tine
PROPOSED IMPROVEMENT LOCATION:
Address: 1 a A�e 0 e, Y2I ,
Legal Description:
Property Tax ID #. 1--/ S'G - .SCS - 12, 7 - U LjG, _ 7 Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: j
'l
remove existing pedestal install new 150 amp meter combo pack on 2" alum strut stand
CONSTRUCTION INFORMATION:
Additional work to be nertormea under tnis permit - check ail t= apply:
0HVAC Gas Tank ❑Gas Piping Shutters n
lo
�..t Windows/Doors
Electric Q Plumbing QSprinklers l Generator Q Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ �' ✓ Utilities: Sewer 0—Septic Building Height:
g
OWNER/LESSEE: CONTRACTOR:
NameCvvr/ w 1, Name: John R Law
h r„ ,)
Address: P 6 l� Glc Company: Laws Electrical Service Inc
City: C, l IV, vv. State: C'r Address: 5158 NW Primm St
Zip Code: 0C., Fax: City: PT ST Lucie
Phone No. a 2 °t 29 3CJ Zip Code: 34983 Fax:
E -Mail: Phone No. 772 370 4357
Fill in fee simple Title Holder on next page ( if different E -Mail: lohniaw5l58@aol.com
from the Owner fisted above) State or County License: 29432
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FL