HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO [MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Plonning and Development ,Services
Building ond Code ,Regulation Division
2300 Virginio Avenue, Fort Fierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT
Address: 9695 Grange Avenue
LOCATION:
Legal Description: Dorian SIC+ Blk B Lets 4 & 5
Property Tax ID #:
Commercial
Residential xx
2310-801-0016-000-2Lot No.
Site Plan Name: Kuhn _ Block No.
Project Name: Tim & Katie Kuhn
Setbacks Front...-_ - Back: _ Right Side: Left Side:
Set 50amp temporary poled
❑HVAC
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: 250.99
OWNER/LESSEE:
ION;
under this permit — cfieck a
Gas Piping
OSprinklers
apply:
U Shutters
Generator
Windows/Doors
Roof
Sq. Ft. of First Floor:
Utilities: SewerSeptic Building Height:
Name Carol Kuhn
Address.
2602 Dave St
Cit Ft Pierce Stat,: FL
i Zip Code: 34982 Fax: -
f Phone Np.772--940-1296
E --Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Roof pitch
Name. Kent Masser
Company.- Blosser Electric
Address. PCS Box 7395 T
City: Fort St Lucie State: Fl
Zip Code: 34985 Fax: 772-337-2699
Phone No. 772-337-9055
E -Mail: nrblossero@gmail.com
State or County License: E13991570
�_
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
si
SUPPLEMENTAL CONST
DESIGNER/ENGINEER:
iNuL M11ca1J1I MORTGAGE COMPANY:
Name:
Address.
City: State:
Zip: Phone.
FEE SIMPLE TITLE HOLDER: � Not Applicable
Name:
Address:
City:
Zip: Phone.
Not Applicable
Name:
Address:
City State
Zip, Phone-,
BONDING COMPANY:
Name:
Address:
City
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
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 d covenants that may restrict or prohibit such
structure. Please consult with your Horne Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, l 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 r rded and pasted on the jobsite
before the first inspection. If you intend to obtain financing, consult th I nder or an attorney before
commencing work or recording your Notice of Commencement.
_
I00
000
J
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this — day of � ---- -, 20 by
(Name of person acknowledging }
(Signature of Notary Public_. State of Florida }
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
REVIEWS
DATE
COMPLETE
INITIALS
FRONT
COUNTER
(Seal)
ZONING
REVIEW
SUPERVISOR
REVIEW
Signature of Contractor/License Holder
STATE OF FLOR�QA
COUNTY OF U\e
4
The forgoing instrument was acknowledged before me
this day of A&, b
los
(Name of person acknowledging )
(S'ignat'ure of NoTary Public- State of F 0tla
Personally Known OR Produced I entification
Type of Identification Produced s_ -
Commission No.
S
4 llly�' JCHANTAL MON TGC
*; Corrmrrlissi n # FF
921
Expires October fi X
SEA TURTLE
REVIEW
MANGROVE
REVIEW
:RY
b