HomeMy WebLinkAboutBuilding Permit Application 01/17/2018 9:08 AM FAX 7724663765 APPLEBEE ELECTRIC 0002/0005
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/17/2018 Permit Number:I I 03 3
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Building Permit ApplicationLZL
Planning and Development Services Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce P'C 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION;
Address: 15601 W. MIDWAY RD
Legal Description: 1/12 36 38 THAT PART OF E 1/2 OF SEC 1-26-38 LYG S OF WHITE CITY RD AND S OF SR 70-LESS
RD RMS AS IN OR 43-397 AND LESS CANAL RS/W AND LESS OKEE RD WIDENING AS IN OR 308-2043....
Property Tax ID#: 3201-133-0005-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE EXISITNG DAMAGED SINGLE PHASE,(300 AMP SERVICE LOCATED BEHIND THE
EQUESTRIAN BARNS
CONSTRUCTION INFORMATION:
Additional work to bffrtormed un er is permit—check all appy.
❑HVAC Gas Tank []Gas Piping n Shutters ❑Windows/Doors
Electric ❑Plumbing Sprinklers ❑Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 5,300.00 Utilities:l Sewer E Septic Building Height:
OWNER/LESSEE.. CONTRACTOR:
Name ST LUCIE COUNTY BOARD OF COUNTY COMMISSIONER5 Name: JOHN M APPLEBEE
Address:2300 VIRGINIA AVE _ Company: JAK, INC. d/b/a APPLEBEE ELECTRIC
City: FT. PIERCE, State:FL Address: P. O. BOX 15
Zip Code: 34982-5652 Fax:(772)462-1704 City: FT, PIERCE, State:FL
Phone No.(772)462-6413 Zip Code. 34954-0015 Fax: (772)466-3765
E-Mail:IVEY-PLATTS@STLUCIECO.ORG 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.
01/17/2018 9:08 AM FAX 7724663765 APPLEBEE ELECTRIC (a 0003/0005
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ER/ENGINEFR: Nnt AnDlicable 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:
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 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 first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencin work or recording our Notice of Commence . —\A) D�D�
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f Owner/Lessee/ ractor as Agent for Owner Si ature o Contractor/Licen older
FLORIDA ST FLORIDA
COUNTY OF ST,LUCIE COUNTY OF ST.Luc,E
The forgoing instrument was acknowledged before me The fnoing instrument was acknowledged efore me
this day of 201 by thisl clay of 20 l�by
JOHN M.APPLEBEE JOHN M.APPLESEE
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signa re of Notary Public-State of Florida) (Signatbre of Notary Public-State of Florida}
Commission No. W126946 97-0-N
Seal) MEIJSSAPARRAWRE C mission No. GG�26946 " e„s�A"'ti, ISSA PARRAMORE
NotaryPpWlC—StdtEefFloridCommissiontGG126946 ? NataryPublc—StateefFlorlda
N CommissionYGG126946
My Comm,Expires Jul 13.202 =ry R, '•a„Oc n: All 23, •.REVIEWS FRONT S R P NS VEGETATION E
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17