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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 7C)SS 4'I Date: Permit Number: I :. .J� :• .. - : ._ .� .. RECEIVED Building Permit Application JUN 14 2098 Planning and,Development Services , 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 X Residential PERMIT APPLICATION FOR' Electrical PROPOSED IMPROVEMENT LOCATION: Address: 15689 Orange Ave Legal Description: Property Tax ID#: 202 1 d2 SIC)0 �� U 4— d 0 Lot No. Site Plan Name: Block.No. Project Name: Setbacks Front Back: Right Side: ! Left Side:. . DETAILED DESCRIPTION OF WORK: t Replace meter panel and power pole CONSTRUCTION INFORMATION: Additional work to •e errormed under this permit–check all appy: I�HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors Electric 0 Plumbing ❑Sprinklers ElGenerator El Roof Roof pitch Total Sq.Ft of Construction: Sq.Ft.of First Floor: Cost of Construction:$ �S�y Utilities:0—Sewer E Septic Building Height: OWNERAESSEE: CONTRACTOR: Name Southwide-Industnes-Incl,'•. Name: Lawrence Stubbs Address:4347;Okeechobee.Rd Company:�S&W Electric Inc, , City West'Palm;Beac.-- ` State F� Address­::501 West Coker'Rd Zip.Code: 33409 Eax: City: Ft Pierce,: :State:FL Phone No.561-688-8833' Zip Code:'$4945 Fax: 464=4273 E-Mail:ahsouthwide@bellsouth.net Phone No.464-6466 Fill in fee simple Title Holder on next page(if different E-Mail:stuboutelectdc@aol.com from the Owner listed above) State or County License: 29442 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:Southwide Industries Inc Name:Lawrence Stubbs Address:15689 Orange Ave Address: 4347 Okeechobee Rd City: West Palm Beach State: City: Ft Pierce State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address:501 west coker Rd 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 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,consulWith lender or an attorney before commencirtdwork or recording our Notice of Commencement. AignatureOwner/L'essee/Contractor as Agent for Owner 'gnats re of Contractor/License Holder i STATE OF FLORIDA // STATE OF FLORIDA COUNTY OF `1_ )C le, COUNTY OF 10) The f1or oing instr ent was acknowledge efore me The oIng instru ent was acknowledge before me this 1 � day of 20by this day of 20 by AN Name of-person making statement Name of person making statement / Personally Known OR Produced Identification Personally Known OR Produced Identification t/ Type of Identifgation Type of Identification Produced L Produced (Signature of Notary Public-State of Florida) (Sign ture of Notary ublic-St to of Florida) „uur,, FARE Commission No. N S Commission No. „�„ .�Parr�., -SEN e.1 RE �QState of Florida-Notary Public *'State ofFlorid,IVIES U'4 *_ Commission:#GG 207464 a,,: Commr 'Notar t �.'iSSI n _XPIrOS �r„i,�� - Ornrni3s, REVIEWS 2' PLANS VEGETATION g922 COUNTER REVIE REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17