HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFOUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application t" ,v 2 2 ?019
Planning p and Development Services I
Building and Code Regulation Division ST. Lucie County, Permitting ,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �F_
PROPOSED IMPROVEMENT LOCATION:
Address: 164 SE Naranja Ave Port St. Lucie, FL 34983
Legal Description:
Property Tax ID#: 3419-540-0178-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Beaulieu
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace existing 200 amp meter can and riser wire. Existing line wire insulation is burnt at lugs. Replace with 2/0 copper.
CONSTRUCTION INFORMATION:
Additional work tonGasTank
orme under this permit—checka appy:
❑HVAC EGas Piping _Shutters Windows/Doors
ZElectric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 1,200.00 Utilities:Sewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Claude Beaulieu Name: John Malanczyn
Address:164 SE Naranja Ave Company: Malanczyn Electric, Inc-
City: PSL State: FL Address: 1535 SE Niemeyer Circle
Zip Code: 34983 Fax: City: Port St. Lucie State:FL
Phone No.772-708-1477 Zip Code: 34952 Fax:
E-Mail: Phone No. 772-263.9129
Fill in fee simple Title Holder on next page( if different E-Mail: jmalanczyn@aol.com
from the Owner listed above) State or County License: EC-0001492
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: Claude Beaulieu Name:John Malanczyn
Address:164 SE Naranja Ave Port St.Lucie,FL 34983 Address: 164 SE Naranja Ave
City: PSL State: City: Port St.Lucie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:1535 SE Niemeyer Circle 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/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Sk. COUNTY OF 6�- Lur'o�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledge before me
this aaday of Qy 2011 by this a'.,-day of 1`v-%gv 20 by
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Name of person making tatement Name of person making sta ement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced L Produced N2L_ fl t—
(Signature of Notary Pub c-State of Florida) (Signature of No ry'.,q tate OfW- 104E GIVE--
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December 16,20
REVIEWS FRO T' ' ISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNT IEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17