HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/04/2018
Permit Number:
W -M
Man 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 X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 2308 N 53rd ST
Legal Description: HARMONY HEIGHTS ADDN BLK L LOTS 14,15 AND 16 (OR 247-314:1812-701: 2725-2359 THRU 2363)
Property Tax ID #: 1431-701-0205-000-6
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 to be erformed 'under this permit — check all apply:
11 HVAC LJ Gas Tank Gas Piping In Shutters a Windows/Doors
❑✓_Electric ❑PGenerator Roof I I Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 660.00
S. Ft. of First Floor:
Utilities:n, Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name SANDRA F SANDERS (LF EST)
Name: JOHN M. APPLEBEE
Address: 2308 N. 53rd ST.
Company- JAK, INC. d/b/a APPLEBEE ELECTRIC
City: FT. PIERCE, State: FL
Address: P. O. BOX 15
Zip Code: *34946 Fax:
City: FT. PIERCE State: FL
Phone No. (772) 332-0183
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 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 recordin.R vour Notice of Commencement.
s
Si nature o caner/Lessee C c r as gent for Owner
Sig ature of ontractor/License 1yol r
S TE FLORIDA
ST F FLORIDA
CO Y OF ST LUCIE
COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me
"° t�
The forgoing instrument was acknowledged before me
this day of .20 by
thisgc day of 20 by
JOHN M. APPLEE�EE
JOHN M. APPLEBEE
(Name of person acknowledging)
(Name of person acknowledging )
(Signature of Notary Public- State of Florida }
(Signa ure of Notary Public- State of Florida )
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification Produced
Type of Identification Produced
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Commission No. ,������., LSSA PAR-RA-MORE-
Commission No. GG126946 .�,.�.
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Notary Public - $t�lt2 Of Florida
- Notary Public - State ofFlorida
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VEGETATION
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DATE
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