HomeMy WebLinkAboutBuilding Permit Application s I
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ALL APPLICABLE INFO MUST BE COMPLETED FOR A.PLICATION,TOBE,ACCEPTED t.
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Dater/2017 ;Permit'Number:
Building Permit Application-
Planning and Development Services
Building and'Code Regulation Division
2300 Wginia
Phone:(772)-462-1553 C
1553 Fax (772)462-1578 Conirnef Cial Residential ix
PERMI_ APPLICATION FOR: Electrical l__
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PROPOSED IMPROVEMENT LOCATION: r=
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Address: 5660tSummerliri Road' -
Legal Description:
Property Tax ID#: 3208-213-0032-000-4 �`', 'Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:- Left Side:
DETAILED DESCRIPTION OF WORK:
Replace meter can, panel,and riser with 200 amp i "Y
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;CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—cneck all appy:
HVAC Gas Tank Gas Piping _Shutters, •. D Windows/Doors
Electric Plumbing"' �Sprihkle�'s ' �Generator i O'Roof 3 � Roof pitch
Total Sq.Ft of Construction: So.Ft.of First Floor:
1500 ... i._ ..
Cost of Construction:$ Utilities: SewerSeptic Building Height:
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OWNER/LESSEE: CONTRACTOR
Name Patricia Modine :Name: Lawrence,Stubbs j
Address:5660 Summerlin Road-- Company: S&W Electric Inc,
City: Ft.PierceState:FL Address: 501 West Coker Road
Zip Code: 34987 Fax: City: Ft.Pierce State:FL
Phone No.772-216-1887 Zip Code. 34945Fax 464-4273
- 464-6466
E-Mail: Phone No.. '
Fill in fee simple Title-Holder on next.page(if different E-Mail: stuboutelectria@aol:com
from the Owner listed above) State or County,License: 29442
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is'required. I,
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ _Not Applicable MORTGAGE COMPANY: _Not Applicable-
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: ,s Zip:, Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: 'Not Applicable'
Name: Name:
Address: Address:
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 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 ns 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 ith lender or an attorney before
commenciog work or recording our Notice of Commencement.
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(agtfature of Owner/Lessee/Contractor as Agent for Owner %jff6t&e-oT Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF COUNTY OF _
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledge before me
this day of ps 20 Eby this$day of o_c 20 1 by
(Name ofperson acknowledging) _ (Name of person acknowledging)
(Signature of Notary Public-State of Florida) _. (Signature of Notary Public-St'&e of Florida}
Personally Known OR Produced Identification • Personally Known OR Produced Identification
Type of Identi ,arid Pfoduced. Type of Identification Produced
LASHAHNAINO 'M- J
t ;.� , LA(Seel)JA.IN ,.
Commission Na,'�t�= Notary Public(Sojbre of Florida. Commission No. o`.:• _ .;-.• GRAM
:My Comm.Expires Dec 20,2018 Notary Public--State of Florida
c ,fF Commission#FFu177249
Bonded through National Notary Assn. ` ,,,off Fto
Revised 07/15/ 01 erg J-�� � bonded th� rdugh National fdotary Assn,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE-- MANGROVE
COUNTER 'REVIEW' •REVIEW REVIEW 'REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS :, •:.