HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c
Date:� 0. Il Permit Number:
Building Permit Application MAR 2 12017
Planning and Development Services
Building and Code Regulation Division PER 11lITTtitlG
2300 Virginia Avenue,Fort Pierce FL 34932 St. Lucie County, FL
Phone:(772)462-1553 Fax: (772)462-1578 Commercial XX Residential
PERMIT APPLICATION FOR: Electrical
PROOSD lMP'ROVEiVIENT'LOCATiON
Address: 7151 S Us 1 Port St Lucie,FI
Legal Description: 3422-211-0010-000-6
Property Tax ID#: 3422-211-0010-000-6 Lot No.
Site Plan Name: Block No.
Project Name: PSL Plaza
Setbacks Front Back: Right Side: Left Side:
�DETAi�LEDDTE,SCRIPTICJN+OF WORK �a �, ,„ � � •� � '---�--`��
Re-energize Electric to building unit.
GfJN5TRl1CTIQN INFU,RMRTION
Additional work toe er ormed under this permit—check a appy:
F1HVAC 11 Gas Tank ❑Gas Piping :shutters Windows/Doors
oElectric 0 Plumbing Sprinklers o Generator Roof Roof pitch
Total Sq,Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 100.00 Utilities:Sewer F]Septic Building Height:
OWNER/LESSEE 4 CONTRACTOR _
Name Port St.Lucie Plaza Name: Kent Blosser
Address:112 Phyllis Court Company: Blosser Electric
City: Elmont State:NY Address: PO Box 7305
Zip Code: 11003 Fax: City: pod St Lucie State:Fl
Phone No. Zip Code: 34985 Fax: 772-337-2699
E-Mail: Phone No, 772-337-0055
Fill in fee simple Title Holder on next page(if different E-Mail: nrblosser@gmail.com
from the Owner listed above) State or County License: EC13001570
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required,
1
SUPPLEMENTAL CONSTRIJGT.ION LIEN LAIN INF�QRNfATION
DESIGNERENGINEER: _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: _Not Applicable
Name: 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 thepermit 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,
accessorystructures,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 yoarTroperty.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
commencingwork or`recordin ur Notice of Commencement. _
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA Q
COUNTY OF---- C�i�l LCL COUNTY OFA (X--Zt1t�
The for oing instrum nt as acknowledged before me The forgoing instrument was acknowledged before me
this day of v J 20/7 by thica day of s 20/f2_by
171'r�1 keli'f ��2S,5cr/' �-�e�n ke-,oF B( nSSer-
(Name of erson acknowledging) (Name of person acknowledging
MP )
(Signature of Not TV ic- late of Florida) ignature Nota Pu lic State of Florida)
/ _ Identification---
T entification--
Personall Known OR Produced Identification r� Personall Kno OR Produced d
Y _
Type of Identific tl Type of Id ication Produced LL-A.f-r
CARLA J.COULTER
J.COULTER
Commission No. =?° °°°~- Notary Publ(6et)ito of Florida Commission No. °P` ? NotatyT'uUlic-State of Florida
:c My Comm.Expires Oct 30,2017 ;'d my Comm.Expires Oct 30,2017 k
Commissitln FF OG7194 k
Revised 07/1` / 0 � =� a � — •
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
COMPLETE
INITIALS