HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1704-0599
C4 5 Ya
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
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�P�f20�POSED�{IIUIPROUEMENT,LOCA4TIQN
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Address: 16675 C-24 Canal Road
Legal Description: 24 36 38 NE 1/4 less E 70 Ft to SLC and less that oaert of W 1/2 of NE 1/4 LYG of existing road (less C23)
together wuth that part of N 1/2 of SE 1/4 LYG E of existing rd and N of C?L existing canal less E 70 ft to SLC
Property Tax ID#: 3224-111-0002-000-2 Lot No.
Site Plan Name: Block No.
Project Name: La Potencia II Farm
Setbacks Front Back: Right Side: Left Side:
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DETAILEDDtESCRIPTIONNOFWORK` xw
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temporary pole
C®NSTRUC�TIONWFORIVIATION
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Additional wor to be nertormed under t ispermit—c ec a appy:
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 600.00 Lltilities:cn Sewer Septic Building Height:
{fi --A -7,,t .5 n P .r A' t` x
OUVNER/LESSEE� K � s t CONTR TORF.Wit
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Name La Potencia If Name: Edward Rose
Address:4036 Pacaya Cr Company: RV Electric
City: Boca Raton State: FL Address: 1748 Costa del sol'
Zip Code: 33487 Fax: City: Boca Raton State:FL
Phone No.561-212-5982 Zip Code: 33432 Fax:
E-Mail: Phone No. 561-368-2022
Fill in fee simple Title Holder on next page(if different E-Mail: ((nib U
from the Owner listed above) State or County License: EC13005738
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
_5"'W E ENTAICONSTRUCT OIVLIE'NLAW INFORMTION n
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DESIGNER/ENGINEER: x Not Applicable MORTGAGE OMPANY: _Not Applicable
Name: AdrianaFinnvold Name: A
Address: 8000 N Federal Hwy Address:
City: Boca Raton State: FL City: State:
Zip: 33487 Phone: 561-3064286 Zip: Phone:
FEE SIMPLE TITrOLDER: _ Not Applicable BONDING COMPANY: x Not Applicable
Name: Name: n ct
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,
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 wor -or recording our Notice of Commencement.
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Signature of /Le�de/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORM / STATE OF FLORID
COUNTY OF �v�i�Gi 1_69COUNTY OF -
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The forg9ing instrume t as acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 �by this �ay off 20 17 by
en_;I t6S
(Name of person acknowledging) (Name of person acknowledging)
L�IaAaa&b //01�a&&ab
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produ Type of Identification P oduced
S
W.-Mfl-'4'
KIM A.NOTORIS $� i.� tpgTORIS
Commission No. " S3yPublic-State of Florida Commission No. NocaryPlt31Ft�§S4a+.eofFlorida
Commission#GG 096212 z . Commission#GG 096212
My Comm.Expires May 9,2021 `• e MY Comm.Expires May
carioca iroug aionaNotary Assn. Bonded through National Notary Assn.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS