HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: (V `.��to' Permit Number: C I
Building Permit Application OCT 2 6 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 Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 4901 Grovers rd
Legal Description:
Property Tax ID#: 1313-132-003-000-1 Lot No.
Site Plan Name: Block No.
Project Name: priest
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install a 120v 20amp dedicated GFCI Circuit
CONSTRUCTION INFORMATION:
Additional work toa er orme under this permit—check a appy:
1-1 HVAC f]Gas Tank Gas Piping _Shutters Windows/Doors
EJElectric ❑ Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 700.00 Utilities:Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Everett Priest Name: Anthony Stumpp
Address:4901 Grovers rd Company: Millennium Contracting Services inc
City: Fort Pierce State:FL Address: 9015 Hobe ridge rd
Zip Code: 34951 Fax: City: Hobe sound State:FL
Phone No.772 466-0374 Zip Code: 33455 Fax:
E-Mail: Phone No. 561 718-9422
Fill in fee simple Title Holder on next page(if different E-Mail: mcsielectric@bellsouth.net
from the Owner listed above) State or County License: EC1300-1885
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Everett Priest N am e:Anthony Stumpp
Address:4901 Gropers rd Address: 4901 Grovers rd
City: Fort Pierce State: City: Hobe sound State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Add ress:9015 Hobe ridge rd 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
commencing work or recording our Notice of Comme cerpent.
4)d')
Signature of Owner/Lessee/Contractor as Agent for Owner SignUgrg& ontractor/License old r
STATE OF FLORIDA - y./�� STATE F FLORID I<
COUNTY OF— �)�6" i� COUNTYOF
��
The for o�instr int was acknowled ed before me The forgoing instru nt w acknowledg efore me
g
this day of C — 20 by this day of - 20
Name of pers n making statement Name of l6erson making siratement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signat (Signa
THRYN e• ��ROBIi)
KAO
• ..
Commis ii7[ ': MY COMMISSION#GG(��2 Comm ber 21,2C&
`: MY COMMISSION#GG0491422
I�
EXPIRES November 21,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17