HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10-13-17 Permit Number: V1 No 03� y
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RECEIVED OCT 13 1017
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 X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line -�-
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Address: 9401 S Ocean Drive Unit 4D
Legal Description:
LIP
Property Tax ID#: 3535 344 0003 160 8 Lot No.
Site Plan Name: Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
REPLACE BAD 150 AMP SINGLE PHASE 120/240 VOLT MAIN BREAKER & ENCLOSURE
AT EXTERIOR OF UNIT
1111 11 W1
Additional work to be Derformed under tis permit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
r 71
Electric Plumbing Sprinklers a Generator a Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ $500.00 Utilities: Sewer F]Septic Building Height:
Name Eileen Fields Name: Kenneth Geremia Jr.
Address: 9401 S Ocean Drive Company: * Gerelco Electrical
City. Jensen Beach State: FL Address: 560 NW Enterprise Drive
Zip Code: 34957 Fax: City: Port St.Lucie State: FL
Phone No. 608-756-8148 Zip Code: 34986 Fax: 772-340-7474
E-Mail: Phone No. 772-201-2194
Fill in fee simple Title Holder on next page(if different E-Mail: bwillard@gerelco.com
from the Owner listed above) State or County License: EC 13003415/SLC 29628
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
11141 1
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 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
commencing work or recording our Notice of Commencement.
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_Signature of owner/ essee/Agent Signature of Contractor/License Holder
STATE OF-FLORIDA STATE OF FLORIDA
COUNTY OFCOUNTY OF Kj— �� C
The forgoing instrumen was acknowledged before me The forg ing instrument was acknowledged before me
this1jdayof ,0eb14&_ . 20 L7—by this ay of 20 by
(Name of person acknowledging) (Name of person acknowledging)
g ature of Notary ublic-State of Florida) (Signature of Notary1P/ublic-State of Florida)
Personalty Known. OR Produced Identification Personally Known /� OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.OG7210VA (Seal) Commission No.(5;6 Uo-� (Seal)
BILLIE F DE ONG :;�4ri;�•. BILLIE F DELONG
My COMMISSION#GG009156 Q MY COMMISSION#
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Revised 07/15/2014 EXPIRES July 06,2020 vi .. EXPIRES July 06,202+:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS -