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Building Permit Application
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: • 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: 5817 S[LVER OAK DR Legal Description: NDIAN'RIVER.ESTATES UNIT 06,BLK 2010TS 47 AND48.(MAP 34/TTS)%.(OR 4025r2881111Y. Property Tax ID#: 3402-6074200-1000-B Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: j.-+DE`TAILE,D'DESCR,IPTION`OF WORK: Add Temporary:Electrical•Pole CONSTRUCTION INFORMATION: A itiona work to e e Orme� vn er: permit—c ec a appy: EIHVAC Gas Tank ,Gas Piping —,Shutters Q Windows/Doors IV'1 Electric 0 Plumbing 05prinklers U Generator E]Roof Roof pitch Total Sq.Ft of Construction: Ft.of First.Flool: Cost of Construction:$ �GUU/ GO Utilities: ptic Building Height:. OWNER/LESSEE:, CONTRACTOR: Name #ILI Name: John Cavnar Address: 4y : kyr5e lJ/4A-- Company: Goldstar Electric,Inc. City: df?—T State:r Address: 3141 SW Dimaftia St Zip Code: Fax: City: Port Saint Lucie State:FL Phone No. 7� - 3x70 •G7 Zip Code: 34953 Fax: E-Mail: Phone No. 772-380-5913 Fill in fee simple Title Holder on next page(if different E-Mail: jcavnar@goldstar-systems.com from the Ownerlisted above) State or County License: EC13002082 If value of construction is$2500 or more,a•RECORDED Notice of Commencement is required. I I i SUPPLEl1 ENTAL CONSsTR CTION.LfEN LAWINFO'RKATIOW', ;DESIGNER// GINEERt _N t Applicable f MOR`TGAf%E COMP/�lVY_e N"otApplitable; !Name: dame: Address: Address: City: State: City: State: Zip: Rhone: Z1p: <Phone: fiEE SiMPIE:TITLTI3OtDER; —NotApplicable B.t31 fDTNG: OMPAN'1f: _Not,Applicable N airier: Native: -Address: j Address: City: City: Zip: Phone: Zip: Phone: A.certify.,that--no walk or,:installation has•co.mmenced prior:'to the issuance of a,permit. St._-Lucie iCountymaakes monepresentstion,that,,is,>granttrlg a�erfmit will avthodzeIhe:errnit holder to build=the.sublect structure Which4s in conflict wlth any applirrableiklome Owners Assaciatio�ctlles;'bylaws or.and.aavenarats'that may restrict or prohibit such structure.Please consult with.your Home Owners.Association and'review-youndeed:for any restrictions which.may apply: -11 consideration of the granting of:this-requested.permit,ti d©hereby-agree that lvwill;in aihrespects,perform,the work ei accordance withthe approved?plans,,thetfdan a.�aiiding Codes and St.Lucie County Amendinents. The following building permit applications ave-exempt from undergoing affull',concurrency review:room additions, accessory structures;swimniin&pools„fences,walls,-signs,screen-,rooms and accessoryuses to anothernon-residential use i 111ARNINC,T901Nf.11i.ER:Yoiarfiallureto ReoordaiNa iceofCommenceme t maty:result n,yourpay ng=twice for irtmpravements to your property.A;Nottce of Cornrri, -, ment rnustbe recvr<ded,and:poosted,'omthe job�site bQfone>'the first inspect-ion yot��rttend t.6,:obtafri froa'rrcing,consult with-Lender•cir an attorney before #commencin work orrecur !npyour,Notice of Cornrnencement.. L. s J$Jigna Le see/Contractor as Agent for owner Pnature-&e6ntractor/utcense,!Hold,!zr 1 ST .TE OF_FIORIDASTA1'F O FLOR1'DAr GOl7NTY OF Sok. _a_� rirOl1TY OF Th.e forgoing instrument was acknowledged before me The#.orgoing instrument was acknowledged,before rare his� ay �f 20 Joy 'this�sday,,ol 20 by t .A 1 } J.Nam f person:acknowledging j 4Name Ifterson acknowledging I i tore f Notary Public-State Florida 1 (Sign .,ure of Notary!?ublic-State lorida ji Personally Known: OR Produced•:identifcat cim Personally Known: OR:ProduceclAdentification, y Type,ofi7dentifcation'Produced Type Afi9derYti'hcation=Produced= Commission;No. f' ( DMMission ft. (Seal) otn oa. LAS ANNA INORM % Notary Public-State of Florida 1 N, « r omm.Expires 20,2018 ,�;��` ”�,': �Abr,� 'F Commission e FF Decc 20,2 }°= Notary p AHAA INGRAM J Reuise&07/1�5/Z01 OFI P,,,`' �* �. - Y ublic-State of Florida Bonded through National Notary Assn. "a" a MY Comm. 18 Expires Dec 20,20 �=fi Bonded _ yr vc n FF 177299 Bonded thro g � I REVIEWS FRONT ZONING SUPERVISOR .. PLANS pC it �M,,11}"jr�littlssn ANGRO.VE COUNTER REVIEW 'f2EV1'E1111 'REVIEW 'REVIEW REVI 'REVIEW: 'NATE ` COMPLETE AlS