HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ff _
Date: Permit Number:
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Building Permit Application
I 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
PROPOSED IMPROVEMENT LOCATION:
Address: 330 Shady Lane
Legal Description:'
Property Tax ID#: �� 1� . J��(�- �V i 'VCTy3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter with new meter main, riser, and wire outside. This is a back to back meter and panel,
we will be removing panel in closet and put circuits in meter main. 2 ground rods and gridge. Run new
AH circuit
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all appy:
HVAC 0 Gas Tank ❑Gas Piping Shutters 11 Windows/Doors
Electric 0 Plumbing OSprinklers FIGenerator El Roof Roof pitch
Total Sq. Ft of Construction: Sli
of First Floor:
Cost of Construction:$ 2300.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameMeghan Braun Name: RobertThompson
Address:1006 Whitecap Ave. Company: R.Thompson Electric
City: Manahawkin State:NJ Address: 439 SE Cork Rd
Zip Code: 08052 Fax: City: PSL State:FL
Phone No.772-678-2630 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-342-2064
Fill in fee simple Title Holder on next page(if different E-Mail: sparks9634@aol.com
from the Owner listed above) State or County License: EC13007306
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
!Name:Meghan Braun Name:Robert Thompson
,Address:330 Shady Lane Address: 1006 Whitecap Ave.
;City. Manahawwri State: City: PSL State:
'Zip: Phone Zip: Phone:
FEE SIMPLE TITLE BOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Ad d ress:439 SE Cork 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 Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Si ature of Con ractor/ ' o der
STATE OF FLORIDA, STATE OF COUNTY OFORIDA
COUNTY OF
The for oing instrymegt was acknowledged before me The fo oing instr ent was acknowledged before me
this day of lJCSC ,
20n- by thisday of 20_D by
Name of person making statement Name of person making statement \
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificatio Type of Identification
Produced— �J Produced
( gnat re of Notary Public-StaA3of Florida T511,9nature of Notary Public- to of Florida)
Commission No. (Seal) Commission No. (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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