HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: y 0
- 3c3
COUNTY
FLORIDA -
11.1.1111.11 Building Permit Application p IVO d Y 10�®
Planning and Development Services esi,,n9 0
Building and Code Regulation Division St L'cie County ent
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 6708 GADDY ST
Legal Description: LAKEWOOD PARK-UNIT 8- BLK 96 LOTS 7 AND 8 (MAP 13/02N)
(OR 4028-719: 4074-2629)
Property Tax ID#: 1301-608-0215-000-3 Lot No.7&8
Site Plan Name: Lakewood Park Block No. 96
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Wire new mini-split A/C unit installed under separate permit. Main unit located outside, roughly center
of house, next to rear wall of house. Three interior units in separate rooms along rear wall of house.
Main unit requires 50 ampere dedicated circuit at 240 volts. Main unit feeds, and controls, interior
units.
CONSTRUCTION INFORMATION:
Additional work to b(e_pL7 rformed under this permit—check all apply:
CI HVAC L..1 Gas Tank ❑Gas Piping Shutters a Windows/Doors
Electric 0 Plumbing EI Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 610.00 +permit Utilities: Sewer El Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Sandra Yong-Duffy Name: Thomas J Quinn
. Company: All Hours, Inc.
Address:9505 Listow ER
City: Boynton Beach State:FL Address: al le • ree
Zip Code: 334 2 Fax: City: Port St. Lucie State:FL
Phone No.(954) 648-0955 Zip Code: 34983 Fax: (772)879-3916
E-Mail: Phone No.
(772) 879-9435
Fill in fee simple Title Holder on next page(if different E-Mail: Th.-WE(,1Cgit3ellsouth.net
from the Owner listed above) State or County License: EC000I 590
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: I 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 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 a• :rney before
commencing ,or: or recordin. iit) Notice of Commencement.
/0'` '� tri.
Si7*: ure of Owner/Lessee/Contractor as Agent for Owner Sig ture of Contra 1cense Holder
STATE OF STATE OF FLORID .
COUNTY OF FLORIDA-5-t-.(. COUNTY OF �.- -L-&_C-u--
The forgoing instrument was acknowledged before me The for,going instrum nt was acknowledged before me
this II day of ,M ,20 ('by this Il day of 20 I VW
fr/°)nie'e : ,‘.-.1 Thomas Quinn
Name of person making statement } Name of person making statement `,--/
Personally Known_ OR Produced Identification (/ Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced FL_13 Produced .F---U-l)
o aria
gnat re of Notary Public=S to of Florida) (Sign e o otary Public-State of rids)
.*.. ,n. 1.. :_ Seal1,PR„P`
Commission No. ( ) Commission No.. ot�a L(Seal)NA INGRAM
`4V,RY r'0,, LASHAHNA IMISI , y` _ ,� '�¢�. Notary Public-State at Florida
N1 °
c; ¢*�Q�s Notary Public-State of flprlda ; ;.1,* c Pc My comm.Expires Decp p g
s,-, a`c flit'COmm Fvn'.n••El, 2Q Pu• •t�o, ..a"t OOm fc�.... �< ,- is
"'in' Bonded thrOugA Aationar; 3
° commissi Jn #FF 177 o ' 6 ,,,,,r.,..__�"F,� PLANS VEGETATION SEA�TORTL'E -M A '. �'i'•i
REVIEWS FRONT ZONING'u ugh NSUt?FaE r � ''. ,,.
COUNTER REVIEW ___ REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17