HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/04/2018 Permit Number:
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 3500 AVENUE K
Legal Description: PLAT 3-SUNLAND GARDENS BLK 40 ELY 1/2 OF LOT 21 AND ALL LOT 22 (0.28 AC) (OR 946-306:1100-479)
Property Tax ID #: 2405-701-0067-000-8
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
,DETAILED DESCRIPTION OF WORK:
REPAIRING HURRICANE IRMA DAMAGED RISER.
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work toffGasTank
r orme 'under this permit — check a appy:
11 HVAC Gas Piping _Shutters a Windows/Doors
ZElectric � PlumbingSprinklers � Generator � Roof I I Roof pitch
f'
Total Sq. Ft of Construction:
Cost of Construction: $ 718.00
Sc.Ft. of First Floor:
Utilities: Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name GWENDOLYN BETTS
Name: JOHN M. APPLEBEE
Address: 3500 AVE K
Company: JAK, INC. d/b/a APPLEBEE ELECTRIC
City: FT. PIERCE, State: FL
Address: P. O. BOX 15
Zip Code: 34947 Fax:
City: FT. PIERCE State: FL
Phone No. (772) 971-5368
Zip Code: 34954-0015 Fax: (772) 466-3765
E -Mail:
Phone No. (772) 466-7930
Fill in fee simple Title Holder on next page ( if different
E -Mail: APPLEBEEELECTRIC@BELLSOUTH.NET
from the Owner listed above)
State or County License: EC #0002956
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 the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Assoclation 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
com-mencinR work or recordinp, vour Notice of Commencement.
r
r UA y � s
S' nature o Owner/Lessee/Contr ct r as Agent or caner Sig ture Contractor/Licen H der
S TE FLORIDA ST F FLORIDA
CO TY O F ST LUCIE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me
this'4� day of , 20 I�' by
JOHN M. APPLEEOF—E
(Name of person acknowledging )
y
(Signatu a of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
Commission No. GG126946
Revised 07/15/2014
REVIEWS FRONT
COUNTER
DATE
COMPLETE
INITIALS
The forgoing instrument was acknowledge before me
this LON day of.�.�,✓ 20 by
JOHN M. APPLEBEE
(Name of person acknowledging)
V
(Signa re of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
.•C�c�Y pt,1 (S
ELISSA PARRAMORE
o m m i ss i o n No. GG 126946
% ry Public - State of Florida
Commission ;'GG ; 26946
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MELISSA PARRAMORE
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Notary Public - State of Florid
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Commission # GG 126946
My Comm. Expires Jul 23, 2021
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