HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `)• f Gi 1—) Permit Number:
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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 xxxx
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 3209 Scarlet Tanager Court
Legal Description: eagles retreat at savanna club phases 2 (pb 43-21)blk 58 lot lot 12 (or 3162-1845)
Property Tax ID##: 3424-702-0022-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
install interlock system for protable generator
CONSTRUCTION INFORMATION:
Additional work to b rtormed under t is permit—check a apply:
E1HVAC Gas Tank E]Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 1146.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Joyce Wayne Name: George Hand
Address:3209 Scarlet Tanager Corut Company: My Electrician, inc
City: Port St Lucie State:FL Address: 750 NW Enterprise Drive
Zip Code: 34952 Fax: City: Port St Lucie State:FL
Phone No.305-343-2796 Zip Code: 34986 Fax:
E-Mail: Phone No. 772-878-3974
Fill in fee simple Title Holder on next page( if different E-Mail: LDIODATO@MIRANDACOMPANIES.COM
from the Owner listed above) State or County License: EC1300398
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable
N a me:Joyce Wayne N ame:George Hand
Address:3209 Scarlet Tanager Court Address: 3209 Scarlet Tanager Corut
City: Port St Lucie State: City: Pert St Lucie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:750 NW Enterprise Ddve 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencl work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY Cl7+ L t A c t t. COUNTY OF . �t..t < I C'
The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this day of E _p- 20 j` by this day of 200 by
C7 �2�ti. ✓ i~7��N t—ef4 J 62 N c
Name of person making statement Name c pers n making statement
Personally Known__Z>� OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 12 Produced
(Signature of Notary Public- to of Florida) (signature of Notary P State of Florida)
, 1I .y LOCI Diodalto ,� ��i! � Loci Diodato
Commission No. ?� C0171ftlinPGG0691258 Commission No. GommissioO*00069258
Expires: Feb. 9, 2021 - Expires: Fab. 9. 2021
Bonded thru Aaron!N '•-,,oa 11;� Bonded thru Aaron notary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17