HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/11/2017 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) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 6789 Mar Pacifico
Legal Description:
Property Tax ID #: 1306-501-0845-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Add circuit for walk-in tub
Aaamonaiwor](10perierrormea unaer tnis permit— cnecK an inat apply:
HVAC _ Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Sq.
of First Floor:
Cost of Construction: $ 400.00 Utilities: LJSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Joseph Young
Name: Lawrence Stubbs
Address: 6789 Mar Pacifico
Company: S&W Electric Inc
City: Ft. Pierce State: FL
Address: 501 West Coker Road
Zip Code: 34951 Fax:
City: Ft. Pierce State: FL
Phone No. 460-2555
Zip Code: 34945 Fax: 464-4273
E -Mail:
Phone No. 464-6466
E -Mail: stuboutelectdc@aol.com
Fill in fee simple Title Holder on next page ( if different
State or County License: 29442
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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: 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 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 your Notice of Commencement.
ature o Owner/Lessee/Contractor as Agent for Owner Sigfture of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L�G� COUNTYOF
The ior oing instrunlent was ackn wledged b
this ay of 0 T
(Name of person knowledging )
(Si re o Public- State of Florida )
Persona
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me The forgoing instrument was acknowledged before me
this day of , 20 by
Commission # 234730 [I
.GGFHExpires �(ayMY
, 2019
Bonded throughNation,!, N. • ;
Revised 07/15/2014
Name of person acknowl
(Signature oTNbtary blic- State of Florida) f }
ersonally Known OR Produced Identification
Type of Identifica ion,
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REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS