HomeMy WebLinkAboutBuilding Permit Application ALL APP�LI�CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�-
, 18 Permit Number: , So t) - Q 2/ 2
La"08
RECEIVED
Building Permit Application
Planning and Development Services MAY 0 7 2018
Building and Code Regulation Division
ST. Lucio County, Permit
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: 18506 Tranquility Base Lane
Legal Description:
Property Tax ID#: 321580100620000 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Service change
CONSTRUCTION INFORMATION:
Additional wor to e Derformed under!his permit–check a appy:
HVAC 11 Gas Tank Gas Piping _Shutters Windows Door
— ❑ Pg Q Windows/Doors
Electric ❑ Plumbing EJ Sprinklers ElGenerator F� Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 2200.00 Utilities:cn Sewer O Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Margaret L Schellenger Name: Edward Flack
Address:18506 Tranquility Base Lane Company: Kilowatt Electric Company
City: Port St Lucie State:FL Address: 1700 nw 22nd Ave
Zip Code: 34987 Fax: City: Pompano Beach State:FL
Phone No. Zip Code: 33069 Fax: 954-975-9946
E-Mail: Phone No. 954-975-8200
Fill in fee simple Title Holder on next page(if different E-Mail: eddie—flack@kilowatt-electric.com
from the Owner listed above) State or County License: EC13001961
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 thepermit 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 r cult in your paying twice for
improvements to your property. A Notice of Commencement must be rec ded a osted on the jobsite
before the first inspection. If you intend to obtain financing, consult wi lenge an attorney before
commencing work or recording our Notice of Commencement.
l�
Signature of Owner/Lessee/Contractor as Agent for Owner Signature f ontractor/License Holder
STATE OF FLORI A �p STATE OF FLORIDA
COUNTY OF ; alt c. o COUNTY OF
The fo going instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of LJ: 20LE by this ') day of 201 by
Name of-person making statement Name of person making statement
Personally Known "OR Produced Identification Personally Known 1/ OR Produced Identification
ation Type of Identification
Produced Produced
MARIBELL RODRIGU
(Sigr y uJJ 5t3��of Arida ) (Sig a re of Notary Public- bf riFialoyCOMMISSION#GG 1 7 8
I�rA FLAB <:
14si y eaMMISSION#FFt §�� ,ope_ EXPIRES:March 4,20
Com
Q ) Commission No. °pFt•• Thru Notary Public
tycpIRds July 14.201s CC-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