HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: !•o �O� ��_ Permit Number: 770 7OL�/ �7
Jun
Building Permit Application
RECEIVED.
Planning and Development Services JUL 2 6 207
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone: (772)462-1553 Fax:{772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
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Address: 550 SW AIROSO BLVD, PORT ST LUCIE, FL 34952
Legal Description• RIVER PARK-UNIT 6-BLOCK 56 LOT 16(MAP 34/28S)(OR 3246-2412)
Property Tax[D#-. 3419-545-0017-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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REPLACE ELECTRICAL SERVICE WITH 150 AMP SERVICE
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HVAC LJ Gas Tank Gas Piping _Shutters �,Windows/Doors
Electric 0 Plumbing Sprinklers Generator a Raof Roof pitch
Total Sq.Ft of Construction: ScFt.of First Floor:
Cost of Construction:$ 500.00 Utilities,nSewer Septic Building Height:
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Name MICHAEL J KAISER Name: KEVIN SMITH
Address:1065 SE DOLPHIN DR Company: EASTERN ELECTRIC SERVICE,INC.
City: STUART State:F L Address: 2221 NW SUNSET BLVD
Zip Code: 34996 Fax: . City: JENSEN BEACH State:FL
Phone No. Zip Code: 34957 Fax;
E-Mail: Phone No. 772-201-8689
Fill in fee simple Title Holder on next page(if different E-Mail: E:ASTELEC@COMCAST.NET
from the Owner listed above) State or County License: EC0002263
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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:
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 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
commencing work or recording our N tice of Commencement.
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Sldnatffre of Owner/Lessee/Co ractor as Agent for Owner Sign to o Contractor/LiceZolder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF 'A �n COUNTY OF� n
The#9�o,ing instrument was acknowledged before me The fing instrument was acknowledged before me
this L`.�day of 20by thisday of 20 Ll by
Kovirr" vlyyl` ? Win ne
(Name of person acknowledging) (Name of person acknowledging)
(Signa ' e of Notary ubl' State of Florida) (Signatur f Notary blic 'tate of Florida) /
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Personally Known OR Produced Ide tification ✓/ Personally Known OR Pro uce I entification
Type of Identification Produced ow i _ ± yC�[� �i�t?yISG Type of Identification Produce
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Commission No. Zl 3 s Virgini
a JComission No. 2 1 21 V�"re
NOTARY PUBOLOR STATE OF F
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C.arxn#FF921325 Expires 9123120 19
comnOrMclaim
Revised 07/15/2014 Expires 912312019
REVIEWS FRONT ZONING -SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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