HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
— Not Applicable
Name:
Address:
City:
Zip: Phone
BONDING COMPANY:
Name:
Address:
City:
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
Not Applicable
State:
Not Applicable
St. Lucie Counter 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 in pection. If you intend to obtain financing, consult with lender or an attorney before
commencing o recordingyour oti e of Commencement.
a /� r
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Sig ure of Owner/Les e/Contractor as Agent for Owner Signature of Contractor/Li se Holder
STATE OF FLORIDA
COUNTY OFA r ,
The forgoing instrument was acknowledged before me
this 1-�,_ day of 4 20 L__�-by
(Name
� (Signature�Ilotary Public- State of Florida )
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this .1_ day of 4)_. . 20 t -)—by
of
Public- State of Florida )
PersonaryKnown OR Produced Identification �- Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced -'.fly _ r.0 c�,Ako
y Craig Felke NOTARY PUBLIC
Commission No. �5'c�L1 �' NOTARY PUBLIC Commission No.(Z63i-Zk1__ ATE OF FLORIDA
STATE OF FLORID.% � Comm# GG036212
1Q�e Expires 1 d/15/2o2o
Revised Q7/15/2Q 14
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6-6-17 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax: (772) 462-1.578 Commercial Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 31 Aqua Ra Dr, Jensen Beach, FL 34957
Legal Description: RIVER WATCH BLK 1 LOT 6 (OR 3881-2404)
Property Tax ID #: 4511-815-0004-000-1
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
DETAILED DESCRIPTION OF WORK:
Wire boat lift installed with SLC permit #1703-0322.
Left Side:
FQ
Lot No.
Block No.
CONSTRUCTION INFORMATION: 1
Additional work to be ertormed under this permit— check all apply:
HVAC 11 Gas Tank Das Piping _ Shutters Q Windows/Doors
Electric El Plumbing Sprinklers Generator 0 Roof I I Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1,200.
5Ft. of First Floor:
Utilities:cnSewerF]Septic Building Height:
OWNERAESSEE:
Name Dawn Jaschinski, Mitchell Jaschinski
Address: 31 Aqua Ra Dr
City: , Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. (561) 302-7974
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Michael Flanagan
Company: First Quality Electrical Service
Address: 2336 SE Ocean Blvd #114
City: Stuart
Zip Code: 34996 Fax:
Phone No. (772) 263-8088
E -Mail: mflan@comcast.net
State or County License: EC13002096
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FL