HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7-28-2017 RECEIVED Permit Number:
EIV � 312017
D JUL 31 2017
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
PERMIT APPLICATION FOR: Electrical
PROPOSE® 1iC11PR0\/EIVIENT LOCATION ' '
_ & Lq
Address: 10701 S Ocean Drive Lot 826 Jensen Beach,-FL-34957
Legal Description. Venture Out at Indian River Inc. Lot 826
Property Tax ID#: 4511-510-0027-000/2 Lot No.826
Site Plan Name: N/A Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
a
EWDES
Installing a new Electric pedestal for RV hook up. FPL required.
CONSTRUCTION.INFORfUTATI,ON
iAdditional work toe nertormed under tis permit—check all appy:
HVAC Gas Tank OGas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 500.00 Utilities:n Sewer Septic Building Height:
OWNER/LESSEECONTRACTOR
s
e
Bro
fE
Name Sharon Cottrell Name: Self
Address:1066 NE Terrace Way Company:
City: Jensen Beach State:FL Address:
Zip Code: 34957 Fax: City: State:
Phone No.772-341-7166 Zip Code: Fax:
E-Mail:lertok@bellsouth.net 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 G.ONSTR-UCTION 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: Add ress:
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 woorrrkkj�or recording our Notice of Commencement.
Sharon Cottrell N
IA_ S
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Martin COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2—% day of�,'�L)—! 20/%--by this day of 20 by
O
Name o o acknowledging (Name of person acknowledging)
(Signatu of Not Public- tate of Florida) (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known OR Produced Identification
ype of Identificatio Produced Type of Identification Produced
•�4�,.Y ,,•� SHERRI MANN
Commission `;c MSSIONFF Commission No. (Seal)
1•a, EXPIRES:October 13,2019
Sanded Rai Not;;Iy Public ;J1
,•
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS