HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED nn
Date: May 17,2017 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 xxx
PERMIT APPLICATION FOR: Electrical -�
PROPOSED IMPROVEMENT LOCATION:
Address: 100 Vindale Avenue,Ft.Pierce,FL 34951
Legal Description: Let 16,Block 2,BEL-At RE ESTATES,according to the Plat thereof on file in the Office of the Clerk of the Circuit Court in and for St.Lucie County,Florida
recorded in Plat Book 14, Page 21;said lands situate,lying and being in St.Lucie County,Florida.
Property Tax ID#: 1312-701-0031-000-9 Lot No.16
Site Plan Name: BEL-AIRE ESTATES Block No. 2
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator El Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 200 Utilitiesflewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:] p
NameTracy Hochendoner Name:
Address:188 Imperial Way Company:
City: Ft. Pierce State: FL Address:
Zip Code: 34951 Fax: City: State:
Phone No.772-777-1363 Zip Code: Fax:
E-Mail:tlisaacs718@gmaii.com Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION'LIEN LAW INFORMATION
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
1 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
commeAcing work or recording our Notice of Commencement.
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Signature of Ow er/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOR � / a STATE OF FLORIDA
COUNTY OF dui f,c1l COUNTY OF
The forgoing instqtdmentAas acknowledged b TO me The forgoing instrument was acknowledged before me
ti!s� r4day of 201by this_day of 20 _by
daie�.
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( ame of person acknowledging (Name of person acknowledging)
i
0
S' a 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 Produced Type of Identification'Produced
AN�REAW.SMITH Com ssion No. (Seal)
Commission No �0 w No M�COMMISSION#000 6561
EXPIRES:June 23,2 1
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS