HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 219118 Permit Number: (o
Building Permit Application RECEIVED
Planning and Development5ervices FEB 1 2 1018
Building and Code Regulatlon Division
2300 Virginia Avenue,Fort Pierce Ft 34982 Permitting Department
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential x It. Lucie Countv
PERMIT APPLICATION FOR: Electrical
Address: 4000 N Highway A1A Unit 1101 Fort Pierce, FL 34949
Legal Description:
Property Tax ID#: 1423-503-0019-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Additional work to be nertormed un er t is permit—check all tiLat appy:
❑HVAC L_I Gas Tank Das Piping _Shutters ❑Windows/Doors
Z✓ Electric ❑ Plumbing Sprinklers ❑Generator ❑Roof Roof pitch
Total Sq. Ft of Construction. Sr ,of First Floor:
Cost of Constructlon:$ 500.00 Utilities: Sewer Septic Building Height:
Name Knockeraven LLC Name: Thomas G.Walton
Address:269 W Lake Blvd Company: L. Walton Electric, Inc.
City: Mahopac State:NY Address: 1135 17th Street
Zip Code: 10541 Fax: City: Vero Beach State:FL
Phone No.1-317-428-1523 Zip Code: 32960 Fax: 772-569-8906
E-Mail: Phone No, 772-569-1547
Fill In fee simple Title Holder on next page(if different E-Mail: waltonelectricinc@gmail.com
from the Owner listed above) State or County License: EC13003596 County:24743
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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
commenoing work or recordin ou tice of Commencement.
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Slgnature o Own r/Lessee ontractor as Agent for owner Signature of Con raetor/ icense Hol er
STATE OF FLQ + STATE OF FLARIQA
COUNTY OF (� _ �,f`/QIr COUNTY OF —1 dA'&-'1 ('
The�ng Instru t was acknowledged 4gfore me The r Ing Instrument was acknowledged before me
this ay of 2011by this a of1.20 6y
(Na person acknowledging) (Nam o person acknowledging)
ure of o a Public-State of Florida) re of Notary Public-State of Florida )
Personals Known OR Produced Identification Personal) Known OR Produced Identification
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Type of Identifica ion Produced Type of Identifica on Produced
Commission No. SARA a ND�90698y Commission 0. 6 N RAII64.
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