HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/5/2017 Permit Number:
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: Electrical
Address: 5502 SHANNON DRIVE, FT. PIERCE, FL 34951
Legal Description: LAKEWOOD PARK -UNIT 12- BLK 158 N 18.75 FT OF LOT 20
AND ALL LOTS 21, 24 AND 25 (MAP 13/12S) (OR 3784-1033; 3973-2414)
Property TaxlD #: 1301-614-0049-000-7 Lot No.
Site Plan Name: Block No.
Project Name: JUDY ROSS
Setbacks Front
Back: Right Side: Left Side:
HURRICANE IRMA DAMAGE - MAST REPLACEMENT - WORK IS COMPLETED AND WAS
DONE AS A WEEKEND EMERGENCY.
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HVAC _ Gas Tank ❑Gas Piping
Electric 1:1 Plumbing Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 1000.00
Shutters F]Windows/Doors
Generator 0 Roof
S4I Ft.� of First Floor: _
Utilities: Ft
rE]Septic
Building Height:
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Name JUDY ROSS
Name: GARETTGUIDROZ '..
Address: 5502 SHANNON DRIVE
Company: COMPLETE ELECTRIC, INC.
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 772-529-2234
Address: 637 SEBASTIAN BLVD.
City: SEBASTIAN State: FL
Zip Code: 32958 Fax: 772-388-2411
Phone No. 772-388-0533
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: mskelley@yahoo.com
State or County License: EC0001911
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: _
Address:
City:
Zip:
ne:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip: _
Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count yy 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 recordine vour Notice of Commencement.
S
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF STwcle
The fg Ding instrument was acknowledge before me
this _day ofO{iYVt 20 by
STATE OF FLORIDA
COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me
this a day of DECEMBER 20 _by
GARETT GUIDR(R I GARETT GUIDROZ
(Name of person acknowledging) (Name of person acknowledging )
Personally Known x
Type of Identification I
Commission No. FF901564
State
OR Produced Identification
Personally Known _
Type of Identification
FF901564
ic- State of Florida )
OR Produced Identification
Public State of Florida
o My C0mr3i3si0n FF 901564 e, A �� o` My Commiasien FF 901564
Revised 07/15/2 l oe`re oe
Expires 09/19/20 i �oirsoT Expirc•s09/19/201911
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