HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETEDFOR APPLICATION TO.BE ACCEPTED
Date: '�. Permit Number: n'�- _
1D
BufOding Permit Appikation AUG 011017
Planning and Development Services
Building and Code Regulation,Division PERDIMmriNG
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone;{772j 462-3553 Fax:(772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT_LOCATION:
Address: 121 Queen Guinevere Court Fort Pierce,FL
Legal Description: QUEENS COVE UNIT 1 8LK 2,LOT E(OR 3871-1335)
Property Tax ID±1. 1414-701-00.16=000-1 Lot No.
Site Plan Name: Block No.
Project Name:Phoenix Realty Homes-Ailotto Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED;:DESCR#PTldN'OF WORK
Install 150amp underground temporary pole for construction of residence
Ct3NSTRt1 Tlt}N'`INFORMATION
w_ _. .
(c
ttiona wor. to e e orme un er this—permit–check a appy:
0HVAC 3 Gas Tank Gas Piping Shutters �Windows/Doors,
Electric f1 Plumbing Sprinklers }J Generator 0 Roof Q Roof pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 500 Utilities:0 Sewer LulSeptic $uilding.:Height:
aan sWL€SSEE: , CONTRACTOR:
Name v Name: le &_ -'
Address: t VI pp MAI CkAK, ompany: ok
City: � +��'�' 1�� State:V40 Address:
Zip Code: Fax: City: State:
PhoneNo. ��� i�� `i� GZL I Zip Code: Fax: t► �4 15-161
E-Mail:_ (i>TU 0 _ I M0..t' -tt4' t Phone No-
Fill in fee simple Title Holden ori ext page(if different E-Mail-` e'mp I slp ,
from the Owner listed above)O State or County License: 2
�
If value of construction is$2500 or more,a RECORDED Notice of commencement is:irequired.�
SUPPLEMENTAL CONSTRUCTION l 1�N LAW-INF -ION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY- Not Applicable
Name: I 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:.
[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 l: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 anothernon-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 your Notice of Commencement. _
Signture of O ner/Lessee/Contractor as Agent for Owner Signature of Contractq/License Holder
STATE OF FLORIDA STATE OF FLORIDA,0
COUNTY OF O ,CJ COUNTY'OF
The forping instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day a cT ( 20/tlbv- this 2 T-ly of ,20 by -
4�/� G��
(Name of rson cknowledging j (Name o persdn acknowledging)
(S' nature of No ry Public-State lorida) /ArAriidftunejf Not ,ublic-State of Florida)
Personaily Known-_OR Produced IdentificationPersonal Known �� OR Produced Identification
Type of Identification.Produced ype of dentification Produced
Com mission No (Seal) Com sick NniervP�bllasmt2�rFI.00 ( al:)
o Toniunyya Ao
�_` �.• UNDA.L RITZAtljFlorida
y Caain��+xian 1 i 207705
• �iVoh► u gc-$18 of
Revised d7/15/ +'tion I FF 13
••. mr.comm:FXPICOs Jul 1
lona ASK
FRONT Z N ( OR PLANS VEGETATION SEA TURTLE MANGROVE
l COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW�� REVIEW
DATE ) �— i
"COMPLETE i III
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