HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: )��i 1 Permit Number:VI ('Y1 I I
Building Permit Application 2 8 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
PROPOSED IMPROVEMENT LOCATION:
Address: 15370 SKYKING DR
Legal Description: TREASURE COAST AIRPARK LOT 67
Property Tax ID#: 4224-501-0067-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
PROVIDE MATERIALS AND LABOR FOR LIGHTS, RECEPTACLES AND DOOR OPENER FOR
NEW AIRPLANE HANGER.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit—check all app y:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1000.00 Utilities:Sewer []Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name VASILE & KRISTINA CIUPERGER Name:
Address: Company: EASTER ELECTRIC SERVICE, INC.
City: WELLINGTON State:FIL Address: 2221 NW SUNSET BLVD
Zip Code: 33414 Fax: City: State: FL
Phone No. Zip Code: 34957 Fax: N/A
E-Mail: Phone No.
Fill in fee simple Title Holder on next page (if different E-Mail: EASTELEC@COMCAST.NET
from the Owner listed above) State or County License: EC0002263
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:VASILEaKRISTINACIUPERGER Name:
Address:15370 SKYKING DR Address:
City: WELLINGTON State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2221 NW SUNSET BLVD Address:
City: City:
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 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 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.
Ig at re of Owner/Lessee/C tractor as gent for Owner Signature ontractor/License 461der
STATE OF FLA STATE OF FLORIl,,,Q�A �
COUNTY OF M4,vn COUNTY OF �1b..C,ft in
The forgoing instrument was acknowledged¢efore me The forgoing instrument was acknowledged efore me
thisdg��dayofQ��e� 20 by this day of �<<t�wlca�_ 20 y
CO3C*'%4-J gVe.ljih (TV
Name of person making statemehA Name of person making statement
Personally Known OR Produced Identification k Personally Known OR Produced Identification X
Type of Id tificati Type of I tific do
Produced 9e— Produced
(Signa of Notary Public-State of Florida) (Sig otary Public-State of Florida)
Carlene EddlundiChen Carlene Edi
Commission N I NOTARY PUBO d-ommission N l 1 S5"l Chen
+STATE OF F14*10A NOTARY P B C
CO ITN O11 STATE OF IGA
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REVIEWS FRONT ZONING SUPERVISOR VISOR PLANS VEGETATION SEA TURTLE MANGROeV�/�
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17