HomeMy WebLinkAboutBuilding Permit ApplictionALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO SE ACCEPTED
Date: 12/07/17
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 xx
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Ad dress: 1409 NW L.ancewood Terrace, Palm City Fl. 349-90
Legal Description: Harbour Ridge -Plat guo Lancewood Village Unit 19 or 2580-904;3940-2502
Property Tax ID #* 4426-804-0029-000-7
Lit N.
Site Plan Name: c N.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DET. AILED i
RI-PTIO,N OF'WO'RK.
Power for 5 Shutters- Provide GFC1 Circuit
HVAC
nV Elec
6&wv�
Total Sq. Ft of Construction:
Gas Tank
permit — check all
Gas Piping
apply:
Shutters
Windows/Doors
tric Plumbing Sprinklers � Generator � Roof Roof pitch
Cost of Construction: $ 600.,00
Sq. Ft. of First Floo
Utilities:
r:
>eptic Building Height:
OW'NER/LESSEE.
CONTRACTOR:
Name
;'
Name: David A. Birth
Address:
�`"� IV � L�1' Y�-1��i„�Z;? �� �� ii
Company: Camouflage Electric Inc.
CiC�.��1f1
Nk
cm"M1'� i1 Sta # e: �
Address,* 460 NW Concourse Place Ste 11tY*
Zip Code:.
� � � t;�' Fax:
City: Pt St Lucie State: FL
Phone No.
Zip Code: 34986.Fax: 772-340-0560�
E-Mail:
Phone No. X72-340-0111
Fill in fee
simple Title Holder on next page (if different
E -Mail: David bcei @outlook.com
from the
Owner listed above)
State or County License: EC13001924
If value of construction i's $2500 or more,, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL. CONSTRUCTION LIEN LAW WFORIVIATION:
DESIGNER
/ENGINEERP Not Applicable MORTGAGE COMPANY, Not Applicable
Name, N a me: David A. Birth
Add reSS: 1409 NWLancewood Terrace, Palm City FL 34990
Address:
Clt�/: Pt St LucieSCit State&yState,,
Zip:
Phone Zip: Phone.
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY., Not Applicable
Name:
Name.
AC+CI ieSS:460 NW Concourse Place Ste 11
Address:
I
City: City:
I
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 Countymakes no representation thatis granting a permit will authorize the Permit holder to build the subject structure
which is in contlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
a
structure. Please consult with Vou r Home Owners Association and review Vn" r d Ppri fnr n nV rpctri tinn r... whi rh mn anni��
In consideration of t
in accordance with t
V V I y
he of this requested permit, I do hereby agree that I will, in all respects, perform. the work
he approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a fullconcurrency V1 w: room additions,
accessory structures., swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNINGfor
TO OWNER* Your to Record a of result in your paying twice
improvements to your property. A Notice of Commencement must be recorded and posted on thejobsite
before the first
inspection. If...6u intend to obtain financing, consult with lender or;an attorney before
Z
coming �corc�ng your Notice
of Commencement.
f
I
-boom I
Signatu
ATE
f Owner/le
F FLORIDA
COUNTY OF
The r oing instr
this day of
/Contractor as Agent for Owner
ent was,
P ( e: (11
50 R ThlTel M, W!
efore me
by
Signa
It UF FL
tuA of Contractor/LicenseHolder
COUNTY OF
The f ring instr
th1is ay of
MENAM
ent was acknowledge, efore me
< 20 11by
Name of person king statement 1;W Name -of - -person aking statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(signature of Not I U411i (Signature of Nota U 0TF1
y P& PEREt
a ,, TIN.
0 PEREZ Notary PQ -,Mate
Notar P of FloridaCommission No. e ommission o.,VMte of Florill cornmisGQ 02155
9j IQ;`; VA( °�6 T1N0, aY bij C N M
COMMiUibn # GG my Comm062155 Expires A
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g rip
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Expires
own' (�V As5�.
13dAd fh;amah At
V11 Wit I
unj ary Assn.
REVIEWS FRONT ZONING SU OR PLANS VEGETATION SEA TURTLE MANGROVE'
COUNTER REVIEW REVIEW REVIEW IREVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17