HomeMy WebLinkAboutBUILDING PERMIT TEMP POLE ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO 13E ACCEPTED
Date: Permit Number:
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: To Select from dropbox, click arrow at the end of line
777
Pf OPOV} I C�'i.:El El T 4 T
Address: •, ,... ;: _
Legal Description:
Property Tax ID#: 35�L 7-50 f— 0005--. CO—CO-6 Lot No.
Site Plan Name: Block No.
Project Name: M6618f
Setbacks Front Back: Right Side: Left Side:
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CO.NSTRUCTIGN INFORM,TInI [:
Additlonal work to be De orme under t is permit--check all a}-p y:
[ HVAC Gas Tank ®Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers I Generator Roof
Total Sq. Ft of Construction: 5 Ft.of First Floor:
Cast of Construction:$ Utilities: _Sewer El Septic Building Height:
DWNER LESSEE F CQI�TRACT 7R
Name Qltif} Name:
Addres 5(4) Af S Company: 4c=A-rF life
City: fAIF,CA._3J- State•Fl. Address: Pi-
Zip Code: -5-3 i56 Fax: City: Rey-1 -';- LoCt6 State; FL
Phone No. 7]P-- 0�79�-?/-7 Zlp Code: 3`7 ct Fax.
E-Mail: Phone No. 72ol-3 70-57SS
Fill In fee simple Title Holder on next page(if different E-Mail: D0IR.mo1Q4 Q, 477-,Al F-7'
from the Owner listed above) State or County License: f-C 000307 Q.
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated-
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 for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the W inspecti9n9 If you intend to obtain financing,consult 'th lender or an attorney before
comment' work or Pdedirding your Notice of Commencement.
Signature of Owne/Agent/Lessee Signature of Cant ctor/License Holder
STATE OF FLO DA STATE OF FL R,�D^A
COUNTY OF �� - COUNTY OF r VA a r-�-+0
The forgoing instrument was acknowledged before me The for Ding instrument was acknowledged before me
this�1day of taLC MLe e r ,20 0 by this 1 day of 20 1-7 by
(Dame of person acknowledging) (Name of person acknowledging)
_L�Cwl C�
l ° �1
(Signature of Notary lic-State of Florida) (Signature of Notary Pu c-State of Florida)
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Identification Produced Ort\fers Type of identification Produced,i� /er-s t,C-evim
Commiss n,Nfa ^rf;•., ROSANNAS.LEWfS (se ) Commiss n O
otary u ic- tateoiFlorida ,c�„� r� °^�^m"R;^�9,tE:Wis al)
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R CommissianGG092355NateryPUbIiC-StateafFlorida
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SUPERVISOR PLANS MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
HATE
COMPLETED
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ACCURATE ELECTRICAL CONrRAcnNG,INC.
7300 GULIAYMPLACE
PORT Sr LUCIE,FL 34952
772-878-91.71
CELL 772,370-5755
FAX-878-2854
DCVRANCIIBATIMT
-FEMPIPAey POD
150 AMPS ELECT.
METER W 1670 AMP 0
MAIN DISC & :50 AMP ETE _-
O.C.P.D. ��
Z' RGC
EMPTY CONDUIT G 1 ## 4 TW CU IN 1/2'
TO 'E.P.&L.
TO COLD WATER PIPE
SERVICE FROM
TRANSFORMER GROUND WIRE TIED TO STRUCT. O - / i,Gu �` �' ``�
STEEL IN FOUNDATION.
GROUNDING ELECTRIC CONDUCTOR MUST BE
CONNECTED TO- OUTSIDE RE-BAR W MIN NO
PLASTIC UNDER RE-BAR 20 FEET NEAREST OUTSIDE
OF FOOTING tAEC 250.52A (3)
ELECTRICAL RISER N.T.S. r