HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/07/2018 Permit Number: /1 U I y
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Building Permit Application MAR - 7 YOio
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
PRO
POSED,,I,p,'R01/EM.ENT owl,
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Address: 7403 Pensacola Road, Fort Pierce, FI, 34951
Legal Description: LAKEWOOD PARK-UNIT 6-BLK 67-A LOTS 17 AND 18 (MAP 13/02S) (OR 3649-167)
Property Tax ID#: 1301-606-0216-000/4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE CRIPTION OF WORK, f g = F
Replace underground cable and conduit from hose-to service pole.
C7QNSTRUCTIQN INFORII/IA11C3N 4
iAdditional work toe performed under this permit—c ec a appy:
HVAC Gas Tank F]Gas Piping _Shutters a Windows/Doors
Electric ❑ Plumbing []Sprinklers ❑Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 350.00 Utilities:Sewer[]Septic Building Height:
C►INNERf LESSEE CONT RACTOR
Name DAVID STALLINGS Name:
Address:7403 PENSACOLA RD Company:,
City: FORT PIERCE State:FL Address:
Zip Code: 34951 Fax: City: State:
Phone No.772-828-3788 Zip Code:` Fax:
E-Mail:OBOE234@LIVE.COM Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPL€ME'NTAL CONSTRUCTION LIEN.LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
N am e:DAVID STALLINGS Name:
Address:7403 Pensacola Road,Fort Pierce,FI,34951 Address: 7403 PENSACOLA RD
City: FORT PIERCE 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 ontractor as Age for Owner Signature of Contractor/License Halder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF
The for Ding Inst ent was ack owledg efore me The forgoing instrument was acknowledged before me
this:Tday of 20LI by this day of 20_ by
$d1z 1 0—PLL) ISCS S.
Name of person making statement o/ Name of person making statement
Personally K wn OR Produced Identification Personally Known OR Produced Identification
Type of IdentifI t'on _ Type of Identification
Produced Produced
(Signature o1yotary Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17