HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED "?V QVEMENT LO�ATIIQN:
Address: 4645 NORTH US HIGHWAY 1 FORT PIERCE
Legal Description: PLOT OF INDRIO UNIT 1 BLOCK 17 LOT 5
Property Tax ID #: 141660100590003
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK.
Right Side: Left Side:
Lot No.
Block No.
Ft. Pierce Utility Authority requested that the owner have a licensed electrical contractor make sure
that the building is up to code.
Acianionai worK to ae perrormert under this permit-- check all apply:
HVAC L_J Gas Tank 0Gas Piping _ Shutters a Windows/'Doors
ZElectric 11 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFtFtj. of First Floor:
Cost of Construction: $ 1,000.00 Utilities: Sewer E]Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name &C>EMC-0 i I c -
Name: PAUL ROMANO
Address: 9SUS '(bo_(-cAwu
Company: AAPEX ELECTRIC INC
City: (,r Q, State:L
Zip Code: A,& -.Q Fax:
Phone No.
Address: 561 SW BILTMORE STREET
City: PORT ST LUCIE State: FL
Zip Code: 34983 Fax: 772.785.7058
phone No. 772.607.9494
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: AAPEXELE CTRIC@YAHOO.COM
State or County License: ER13014699
Iwa,uIW LJ1 t VMPL1ucuon 1b ?cavo or more, a K[LUKutu ryovice oT Lommencement Is required.
,SUPPLEMENTAL CONSTRUCTION LIEN LAW iNFORMATIO
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name,
Address,
Address:
City: State:
City State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Addres,,_
Address:
City:
City:
Zip: Phone:
Zip: Phone:
vWINCK/ L.UN I KAL I UK AI I-IUVIT: 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 snakes 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 tt b f
n a orney a o
are
commencing 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 OF_ ST. LkXu e
COUNTY OF,
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 9,Lp day Of 120 11 by
this 26 day of SEPTEMBER 2011 by
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
{ nature of Notary Public -State of Florida j
JAIME L HARNM
{Si nature of Notary Public-Stoaee£Florida t
Commission No. l; 9 ,; , MYOWAPM#GGO"1?2
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Commis$ion NO. GG069322 * • * 0GG00122
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REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. $/2/17