HomeMy WebLinkAboutBuilding Permit Application 02/08/17 04:03PM CompleteElect 7723882411 Pagel
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (i
Date: Permit Number;
DSII. II IIIIIIII ,III ,
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 X
PERMIT APPLICATION FOR: Electrical
Address: 223 EASY STREET,FT.PIERCE,FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT-D3-BLK 15 LOTS 22 AND 23(MAP 3411 DS)(0.96 AC)(OR1484-12)(OR 3944-2478)
Property Tax ID 0: 34fl2.604-0048-000-5 Lot No.
Site Plan Name: Block No.
Project Name: ERIK 8 HEATHER HEDAL
Setbacks Front Back: Right Side: Left Side:
SERVICE CHANGE
ittonawor o e orme under=eCK a appy:
HVAC EjGas Tank _Shutters Windows/Doors
Z✓ Electric 0 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: SQ.Ft.of First Floor:
Cost of Construction:$ 1500.00 Utilities:r Sewer U Septic Building Height:
_ d
Name ERIK S&HEATHER R HEDAL Name; GARETT GUIDROZ
Address:228 E EASY STREET Company: COMPLETE ELECTRIC,,INC.
City: FORT PIERCE State:FL Address: 637 SEBASTIAN BLVD.
Zip Code: 34982 Fax: City: SEBASTIAN State:FL
Phone No.772-332-2678 zip Code: 32958 Fax: 772.386-2411
E-Mail: Phone No. 772-388-0533
Fill in fee simple Title holder on next page(if different E-Mail: mhatffeld(gornpieteelectricinc.com
from the Owner listed above) State or County License: EC0001911
R value of construction is$2500 or more,a RECORDED Notice of commencement is required.
02/08/17 04:03PM CompleteElect 7723882411 Page 2 ;
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable .
Name: Name•
Address: Address•
City: State: City: State:
Zip: Phone; Zip: Phone:
FEE SIMPLE TITLEHOLDER: _,_-,Not Applicable BONDING COMPANY: Not Applicable
Name: Name.
Address: Address-
City Cfi"
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 our Notice of Commencement.
_Signature of Owner/Lessee/Agent Signature of Contractor/License Haider '
STATE OF FLORIDA STATE OF FLORIDA.
COUNTY OFM.Luem COUNTYOFsi.—a ,
The fo Ding instrument was ackn wledged before me The forgoing instrument was acknowledged before me
this day of Fr6Ru_ 20 1�by this a day of FaaRu"'t� 20i i by
GARETT GUIDROZ
(Name of persona knowledging) r (Name of person acknowledging)
OoA
(Signature of Notao Pybllc-State of Florida) (Signature of No ry ublic-State of Flo y'rlda)
Personally Known oR Produced Identification Personally_ X OR Produced identification
Type of identification Produced Type of Identification Produced
Commission No.FFIOk 5fa I Commission No. FF9a1864
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tip►r Notary Pubtio S tate of FloridaHrdfi IN
Notary Fubtlo State at Florida
�p , y c + � MY cam as FF 901564
Revised 07l i s/ i M9 Commission FF 901564 '7�
or�d expires 4911912418 ��w Expires 6911912019
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