HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
R
Building Permit Application
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: 4885 River Oak LN Fort Pierce, FL 34981
Legal Description: RIVER OAK ESTATES WLY 1/2 OF LOT26 AND ALL LOT 27(0.35 AC) (OR 3682-2954)
Property Tax ID#: 2430-502-0026-000-6 Lot No.
Site Plan Name: River Oak Lane Block No.
Project Name: Shimek
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
200 AMP service change
CONSTRUCTION INFORMATION:
Additional work to be oertorm6d under this permit—check all th, apply:
0HVAC Gas Tank ❑Gas Piping En Q_Shutters Windows Doors/
Z✓ Electric Plumbing Sprinklers n Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor: 2193
Cost of Construction:$ 2400.00 Utilities:CnSewer Septic Building Height: 1 Story
OWNER/LESSEE: CONTRACTOR:
Name George J Shimek Name: Donald B Green
Address:4885 River Oak LN Company: Don Green Electric LLC
City: Fort Pierce State:FL Address: 1305 W 1st Street
Zip Code: 34981 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34982 Fax:
E-Mail: Phone No. 772-418-5739
Fill in fee simple Title Holder on next page(if different E-Mail: dongreenelectric@gmaii.com
from the Owner listed above) State or County License: EC13007447
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEIVIEI ENT C NSTRUCTION LIEN LAW INF�RMATI{�N".
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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
comynencing work or recording our Notice of Commencement.
J 411.p s
Signature of Owner/Lessee/Coritrac�or as Agent for Owner Signature of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Martin COUNTY OF Martin
Thefqrgoinginstru e Uas acknowledged efore me The fgrgoing instru ent was acknowledged,�efore me
thi ay of 9,V 20 Mby this day of 20 —jityb'z)-by
am of perso ack ledgin ) (Na a of p on ack owledgin
( i na re of Notary Public-State of Florida) (Sign re kf Notary Public-State f Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produce
JOY TINE COPELAND o��ar pie J C ISTINE COPELAND
Commission No. t�aY.e..a r Commission No. `_ M �IISSION#FF948Q42
LnI MY L1� SION#FF948042
, EXPIRES:JAN 05,2020
EXPIRES:JAN 05,2020
.,
state 1115ul
Revised 07/15/2014
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