HomeMy WebLinkAboutBuilding Permit Application 09/28/2017 2:13 PM FAX 7724663765 APPLEBEE ELECTRIC 0002/0004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f�
Date: 0912812017 Permit Number:
ED
RECEIVE
Building Permit Application SEP 2 8 2017
Planning and Development services PERMITTING
Building and Code Regulation Division
St. Lucie County. FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
P•ROPOS.I_ 'IMPRp1/EIVI,ENT':LOCATION: 7
Address: 4812 N KINGS HWY (POINCIANA CAFE')
Legal Description: 13 34 39 THAT PART OF SW 1/4 OF NW 1/4 LYG E OF KINGS HWY FEEDER RD AND S OF FOL DESC
Property Tax ID#: 1313-232-0001-0004 Lot No.
Site Plan Name:• Block No.
Project Name_ __-
Setbacks Front Back: Right Side: Left Side:
REPLACING TWO (2) DISCONNECTS
.!�aNSTRU.CTEarI'v1,.,I.NP.�i2'I�ATIQN� ' - _ '�:�::� ; .:. •::-.:_ :; ( =-
Additional worKto be er orme un er this permit—cheek a appy:
HVAC Gas Tank ❑Gas Piping _,Shutters Q Windows/Doors
ZElectric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: ,S Ft.of First Floor:
Cost of Construction:$ 1,800.00 Utilities:0Sewer 0Septic Building Height:
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Name INDRIO RETAIL LLC Name: JOHN M.APPLEBEE
Address.725 CONSHOHOCKEN ST aDCompany: JAK,INC.d/b/a APPLEBEE ELECTRIC
city: BALA CYNWYD State:PA Address, P-O-BOX 15
Zip Code. 19004 Fax: City. FT.PIERCE State:, FL
Phone No.(954)453-605.2Zip Code: 34954-0015 Fax: (772)466-3765
E-Mail: Phone No. (772)466-7930
Fill in fee simple Title Holder on next page(if different E-Mail: APPLEBEEELECTRIC@BELLSOUTH•NEr
from the Owner listed above) State or County License: EC x#0002956
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
09/28/2.017 2:13 PM FAX 7724663765 APPLEBEE ELECTRIC 0003/0004
':SUPP:LEM�ENTALCONSTR:UC1`'ON`:LIEN LAIN INFORM°ATION::
DESIGN ERANGINEER: _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:
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 alb 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 work or recording our Notice of Commencement.
A- /10 ng'W'L (':�'A- A4 &JW2 S
Vignatur' o owner/ a ntractor.as Agent for Owner S, nature f ont act&/ c ns Holder
F FLORIDA S F FLORIDA
OF 3TLUCIE COUNTY OF STLUCIE
The forgoing instrument was acknowledge1�before me The forgoing instrument was acknowledged before me
this day of_ ;'I-- 4 +L_ 20 —I by this'Al",day of 20 1�by
JOHN M.APPLE6EE JOHN M.APPLEBEE
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of identification Produced
Commission No. GG126946 a I) Commission No, GG125946
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MELISSAPARRAMORE NotaryPablic-5aofla
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Commission#GG 126946 MyCOmmExpie5JU2,2U21
Comm,Ex Ires1023,2021Revised 07/15/2014 M 'O
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DATE .
COMPLETE
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