HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/20/2018 Permit Number:
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Building Application
Permit
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
r PERMIT APPLICATION FOR: Electrical
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Address: 3909 SHORESIDE DR., FORT PIERCE, FL 34949
Legal Description: TARPON FLATS SUBDIVISION (PB 69-27) LOT 8 (OR 3793-1161)
Property Tax I D#: 1423-566-0011-000-1 Lot No. 8
Site Plan Name: Block Mo.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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CONNECTING NEW POOL EQUIPMENT INCLUDING PUMPS, HEATER AND LIGHTS.
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Additional o be ertormed under this permit e check a app y:
HVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: t Sc. Ft. of First Floor:
Cost,of Construction:$ 1.400.00 Utilities: Sewer Septic Building Height:
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Name MICHAEL P MCDONALD SR Name: JOHN M.APPLEBEE
Address: 4860 SMALLWOOD CHURCH RD Company: JAK, INC. d/b/a APPLEBEE ELECTRIC
City: INDIAN HEAD State: MD Address: P. O. BOX 15
Zip Code: 20640 Fax: City: FT. PIERCE State: FL
Phone No.(301)908-7070 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.
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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
o ericing work or recording our Notice of Commen ent.
V§ignar of Owner/ ( ee/Contractor as Agent for Owner Sign ure of ontrctor/L c se Holder
OF FLORIDA S TE OF FLORIDAa,
TY OF COUNTY OF
The forgoing instr ment was acknowledge before me The forgoing instr ment was acknowledge- before me
hi&f)6'`�day of 20 l by this;Dt�� day of 20 1 by
Nar4e 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 t Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
,t""J• ��""" `�-, MEl_lSSA PARRAMORE
Pj'•,, ME ! SS,A P RRAMORE p ��`,�?�Y P(�
Commission Now': Notari�iStateofFlorida Commission No. l 1 �_°� ��=�SyPublic-State of Florida
_ y =
• •- Commission GG 126946 -• * •= Commission GG 126946
My Comm.Expires Jul 23 2021 :°� moo`;: My Comm.Expires Jul 23,2021
. �'� ,''' OF °�'�` Bonded through National notary Ass
o....I horded through National Notar Assn. �� I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED -
DATE
COMPLETED
Rev. 8/2/17