HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2
Date: 6/4/18 Permit Number: Q� 3
Q�Vffl'77� MR
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 X Residential
PERMIT APPLICATION FOR: Electrical
Address: 605 Kitterman Road
Legal Description: KITTERMAN (PB 55-32)TRACT A(4.852 AC) (OR 4007-984)
Property Tax ID#: 3415-707-0001-000-0 Lot No.
Site Plan Name: Block No.
Project Name: ADVANTAGE SELF STORAGE
Setbacks Front Back: Right Side: Left Side:
1E:- a
DST LEiDE CRI�TI3)1G�Q, tlCh �
. ,., e,
Temp service for Job Trailer and Site
GC is Welsh Contruction and thweir Permit# is 171200019
r - m "�'.` ., aim
F TRIC SIN=F�3RMA, I ,, x y
3.,._ 9, ,,.....m..�—en._e3� ..... .., t:. ...
HVAC Gas Tank Gas Piping _
«.w,
Additionalworkto a ne orme under this permit—check a appy:
_ ❑ p' g Shutters ❑Windows/Doors
ZElectric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S n
of First Floor:
Cost of Construction:$ �� . Utilities: _Sewer❑Septic Building Height:
QWNE LESSEE CQNTRACOR
Name Name: Garett Guidroz
Address: Company: Complete Electric, Inc.
City: State:NY Address: 637 Sebastian Blvd.
Zip Code: 11746 Fax: City: Sebastian State:FL
Phone No. Zip Code: 32958 Fax: 772-388-2411
E-Mail: Phone No. 772-288-0533
Fill in fee simple Title Holder on next page(if different E-Mail: info@completeelectricinc.com
from the Owner listed above) State or County License: EC0001911
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SF �LEM�N AL ONOI�IN�FOEtMAf�31y
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: N a me:Garett Guidroz
Address:605 Ktterman Road Address:
City: State: City: Sebastian State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Add re ss:637 Sebastian Blvd. 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 an 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.
X
Signature of Owner/Lessee/Contractor as Agent for Ow Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF __:I�cLL-w., R.'v emit/- COUNTY OF 71�-cL4,
The for oing instrument was acknowledged before me The for oing instrument was acknowledged before me
this - day of t'�t_ ,20_S by this T day of �,) n e— ,20Jk by
C�ar-A 9• 6,ki L-�fi-o (o 6we4- P. G 0 L a ro-7-
Name
zName of person�aking statement Name of perso aking statement
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
If J14W/ 4::t
(Signa t of Notary P blic-State of irida) t re of Notary ublic-State of F rida)
� a�) CYNTHIAS.INELFOR .6r'' �THIAS.WELFORD
Commission No. ;=g MY COMMISSION#FF 21 7¢2om ission No. I r T_ •_? "'-
3 MISSICN#FF 218742
°Y S:June 17,2 1 : • +�
g :.=
EXPIRE;* rt+6tere :9� Pc EXPIRES:June 17,2019
o Bonded ThN pd�. Banded Thru Notary Public Undenxdters
°fu. rrav+� n••`
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17