HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:J& 2017 1 f S Permit Number: �v '0
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Building Permit Application FEB 8 2018
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: 10500 W.Midway Rd
Legal Description:
Property Tax ID#: 3303-223-0001-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Wire Shed e d,-
CONSTRUCTION
LCONSTRUCTION INFORMATION:'
Additional work to bffrtormed under this permit–check a appy:
❑HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing E]Sprinklers ElGenerator F—]Roof Roof pitch
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 500 Utilities: Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Dan Hurta Name: Lawrence Stubbs
II
Address 10500 W.
Midway
R
d
Company:YP
City: Ft. Pierce State:FL Address: 501 West Coker Road
Zip Code: 34945 Fax: City: Ft.Pierce State:FL
Phone No. 772-370-1147 Zip Code: 34945 Fax: 464-4273
E-Mail: Phone No. 464-6466
Fill in fee simple Title Holder on next page(if different E-Mail: stuboutelectdc@aol.com
from the Owner listed above) State or County License: 28442
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
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 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
commencirIg work or recording your Notice of Commencement.
s
gnature of Owner/Lessee/Contractor as Agent for Owner . nature of Contractor/License Holder
STATE OF FLC)jn�t STATE OF F ORI
COUNTY
COUNTY OF CTld�['�
The f going instrum t was acknowledge -kefore me The forgoing instrum t was acknowledge efore me
this Y day of 20 Lby this_K day of 20 by
,L 4�0)eu/ sD-i2.R��S
(Name of pers acknowledging) (Name of person cknowledging)
(Signature of No V
��Procluced
ate of Florida) (Signature of Notary Pu is State of Florida)
Personally Known Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS