HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '1
Date: �J`�\b�T_ Permit Number: `1 o 5- 6 ole_
RECEIVED MAY 10 2017
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 6609 Woods Island Circle apt 105 Port St Lucie FL 34952
Legal Description:
PropertyTaxlD#: 3y\5- 50)-005' - Ob0 '� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 100 Amp wires from meter 100 Amp breaker to main lug panel in unit 105. 3) #2 copper and
1) #6 ground
CONSTRUCTION INFORMATION:
Additional work to. e performed under tispermit-check all appy:
HVAC 0 Gas Tank RGas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2300.00 Utilities. Sewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name HOA _& {/.L ` L L Name: RobertThompson
Address:_] 3OV L.l 7� ��' Company: R.Thompson Electric
City:l'�'fo4'n Nv f9c1_/k State: Address: 439 SE Cork Rd
Zip Code: ;3,-7G6.O Fax: City: PSL State:FL
Phone No. Zip Code: 34984 Fax:
E-Mail: Phone No. 772-342-2064
Fill in fee simple Title Holder on next page(if different E-Mail: sparks9634@aol.com
from the Owner listed above) State or County License: EC13007306
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
commencin k or recording our Notice of Commencement.
�- s
ture of Owner/Lessee/C or as Agent for Owner Si" ature of Contractor ic` o der
STATE OF FLORIDP STATE OF FLORJDAk u ,
COUNTY OF Sk. 1-�c COUNTY OF S . A- c%
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this\O day of rMq^V 2011by this\d day of L\1\ • ,20 by
�O,PtC Vs pS01n \\Ub-,,-cA \f%om j? SC5
(Name of person acknowledging) (Name of person acknowledging)
t�7
(Signature of Notary P lic-State of Florida) (Signature of Notary P lic-State of Florida)
Personally Known OR Prod ced j1dentification Personally K wp........
Type of Identification Pro ice � �"='�°�°'s"""�"' Ype of Iden `t"rti odd N tiff lAJEN
I 5 �*N :e= a $$I6N GO 022023
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Commission No. �� I �S:December 1"u,2020 i;,COmmI5510n O:• BHndA otarypublic a uv tars
cF F�„• Bonded Thru Notary Public Underwriters I;y
Revised 07/15/2014
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DATE
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