HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: 01/21/2018 Permit Number: qo d \_d
Building Permit Application RECEIVED
Planning and Development Services JAN 2 3 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 3265 S US HWY 1 (LOTS 15,16,17,18,18A, 18B)
Legal Description: MARAVILLA GARDENS S/D-UNIT THREE-LOT 179-LESS US 1-(OR 1899-2440)
Property Tax ID#: 2427-601-0054-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
UPGRADE ELECTRICAL SERVICE FOR SIX LOTS
[CONSTRUCTION INFORMATION:
Additional work toa nerformed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters a Windows/Doors
ZElectric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 8600.00 Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name PINE VIEW MHP C/O RIVERSTONE COMMUNITIE: Name: JEFFREY R. WAITE
Address:6400 TELEGRAPH RD-SUITE 2000 Company: INFINITY ELECTRIC CO INC
City: BLOOMFIELD TOWNSHIP State:MI Address: 630 TALL PINES RD
Zip Code: 48301 Fax: City: HAVERHILL State:FL
Phone No.772-293-0069 Zip Code: 33415 Fax: 561-588-3805
E-Mail:KCONTI@RIVSTONE.COM Phone No. 561-662-9299
Fill in fee simple Title Holder on next page(if different E-Mail: INFINITYELECTRIC@BELLSOUTH.NET
from the Owner listed above) State or County License: EC-13005456
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:
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.
Signature of Owner/Lessee/Contractor as Agent for Owner Sig f
t e of ontrac or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �� _ COUNTY OF
The forg instr ent was acknowledged efore me The forgoing instrument was acknowledged before me
this day of 201-6 by thisa3 day of3h{1 20_ by
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Name ot peaking statement Name of person making statement
Personally Known rson�OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced F 10 L
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(Si ur of No I (Signature of N - ,Q��i�GiVENS
ri°`•in:::4 .. JEFF MTE s :`'�c's
Y COMMISSION#GG 022023
MY COMN:SS F 91tiY5 r '^ 2020
Commission No. " ExPiRES: h -5.2020 Commission No. PIRES:De e1�
Pc ded Thru Notary Public Underwrite'.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17