HomeMy WebLinkAboutBuilding Permit Application From:I Alex Lopez Fax:(772)621-5959 To: Fax: (772)462-1678 Page 3 of 5 10 312017 2:25 PM
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
e:?
Date L
1,4 1 Permit Number:
Building Permit Application NOV 13 2017
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: Electrical
Address. 28 TEMPLE AVE.FORT PIERCE,FL 34982
Legal Description:
Property Tax ID#: 006120 -7 G G Lot No.
Site Plan Name: Block No.
Project Name:
L2- C
Setbacks Front_ Back; Right Side: Left Side:
INSTALL 60 AMP/240 VOLT ClRLIT, SHED 80 FROM EXISTING SUPPLY, UNDER HOME AND
C )
UP TO MAIN PANEL, U1 Y , Id" e,
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77
..........
pla
nal work to be nertormed uncterthis permit—check all inat apply:
OHVAC Gas Tank []Gas Piping Shutters F]Windows/Doors
I Z Electric 0 Plumbing OSprinklers D Generator Roof Roof pitch
Total Sq.Ft of Construction: Scl. Ft.of First Floor:
Cost of Construction:$ utilities: Sewer Septic Building Height:
OW,
W5*0
Name Jane Disney Name: George M.Hand
Address: 28 Temple ave Company: My Electrician
City: Fort Pierce FL Address: 750 NW Enterprise Drive
Zip Code: 34982 Fax: City: Port St.Lucie State:FL
Phone No. Zip Code: 34986 Fax:
E-Mail: Phone No. 772-878-5123
Fill.in fee simple Title Holder on next page(if different E-Mail: alopez@mirandacompanies-com
from the Owner listed above) State or County License: EC13003398
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
From:Alex Lopez Fax:(772)621-5959 To: Fax: (772)462-1578 Page 4 of 5 11/13/2017 2:25 PM
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DE NGINEER: "WNotApplricable 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: TF
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 allrespects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucle 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.
s
fignattirie of Owner/Lessee/Agent _Sin ff_u-r6_of Cdhtractor/License Holder
STATE OF FLORID STATE OF FLORIPA
COUNTY OF_ Lucie_ COUNTY OF__
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_day of 20 LLP-by. this_day of 20 Ito by
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Gieoe"_ 0, . rtnd A "! olooaw- 0 , 0 CAL
(Name of per cknowi ging (Na/,me7of ;b_6nacknowIe 1
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griatbre Of Notary Rubric-State of Florida 1=C13 m atu e of Not y lic-State of Florida
Personally Known L,::_-�611 Produced Identificati Personally Known Lo�-'OR Produced identification 54 N
Type of Identification Produced Type of Identification Produced &k
Commission No Q011- (Seal) v- Commission No. MT (Seal) It
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE REVIEW
COMPLETE
INITIALS