HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: \ fl
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
ED:IMPROVIE T=LOC ;,T N
Address: 9960 S Ocean Dr 1103,Jensen Beach,FI
Legal Description: Miramar II Unit 1103
Property Tax ID#:4502-702-0048-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Spicer Residence
Setbacks Front Back: Right Side: Left Side:
`DETAILED�DESCRIPTION OF WORK: x x'
Kitchen/Foyer remodel — ¢
wAre � e4w'L
CONSTRUCTIONINFC►RMATION F
AaCl
rtiona �wor to e e Orme under this permit—c ec a apply:
E1HVAC -Gas Tank Gas Piping _Shutters ❑Windows/Doors.
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 5425.00 Utilities:n Sewer E Septic Building Height:
OWNER LESSEE ;CONTRACTOR II°
NamesQl;-� � Name: Kent Blosser
Address: t� IaLo Company: Blosser Electric
City:Jense rBeadh State:FL t Address: PO Box 7305
Zip Coder i�� Fax: City: Port St Lucie State:,
Fl
Phone No.989-42 -8402 Zip Code: 34985 Fax: 772-337-2699
E-Mail: Phone No. 772-337-0055
Fill in fee simple Title Holder on next page(if different E-Mail: nrblosser@gmail.com
from the Owner listed above) State or County License: EC13001570
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUP,PCEMENTALCONSTRUCTION.LIEN LAW INFORMATION
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DESIGNER/ENGINEER: V 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 Applici ble
Name: Name:
Address: Address:
City: City: I
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'I for
improvements to property.A Notice of Commencement must be rec nd posted on the jobsite
before the firs ' spec ion. If you int to obtain financing,consult w' ende or an attorney before
comme i work o ecordi otice of Commencement.
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Signature of wner/Lessee/Contractor as Agent for Owner Siltfiature of Contractor/License Holder
STATE OF FLORIDAC /�1 n ��� STATE OF FLORIDA s+
COUNTY OF _��r lX COUNTY OF
The fr g instru t wa a k owl g ore me The forgoing instrument was acknowledged before,mel
this d y of 20� y this WS\day of J u k V 20 11 by
(Name of person acknowl ging) (Name of person acknowledging)
(Signature f Nota y Pu lic-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Pro ed dent ' ipn l Personally Known \/ OR Produced Identification
Type of Identification Produced •. / Type of Identification Produced
J s
Commission No. (Seal) Commission No.&Cr Oct I ek O (Seal) yy!!"•" c GUY R 13OUCHER
••e Y COMMISSION#GG091810
EXPIRES April 09,2021
Revised 07/15/2014 l-
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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