HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/27/2017 Permit Number:
IL
Building Permit Application, DEC 2 7 1011
Planning and Development Services
Building and Code Regulation Division BY: .....................
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 5307 Palm Drive
Legal Description:
Property Tax ID#: 3402-608-0345-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace Riser on metercan
CONSTRUCTION INFORMATION:
Additional workto e e Orme under this permit—check a appy:
HVAC Gas Tank OGas Piping _Shutters F]Windows/Doors
Electric E]PlumbingF]Sprinklers E Generator 11 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 500 Utilities:[]Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Michele Mclean Name: Lawrence Stubbs
Address:5307 Palm Drive Company: P
City: Ft. Pierce State:FL Address: 501 West Coker Road
Zip Code: 34982 Fax: City: Ft. Pierce State:FL
Phone No. 772-342-6928 Zip Code: 34945 Fax: 464-4273
E-Mail: Phone No. 464-6466
Fill in fee simple Title Holder on next page(if different E-Mail: stuboutelecthc@aol.com
from the Owner listed above) State or County License: 29442
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable 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:
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 thepermit 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 frst inspection. If you intend to obtain financing,consult h lender or an attorney before
commen ' work or reCording our Notice of Commencement.
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�gr�a-tu_,e of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI A STATE OF FLORI A
COUNTY OF COUNTY OF Luce
The forgoing instr ment was acknowledf&ed before me The forgoing instrument was acknowledged before me
this day of ��C 2gj7by this day of QC 20 JJ_by
w A'4 ri C k– 4:>'y ') b b 5 �—0,1:w ( '. c Q S o�Li b S
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public tate of Florida) (Signature of Notary P lic-State of Florida)
Personally Known OR Pr E �� dPersonally Known OR Pro ced if
Type of Identificati T Type of Identific tti, �a "' t1iFN5
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Commission No. 1 EXPI ;.�mbe CUM'dISSION
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS