HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED AA
Date: Cc Permit Number:
�4
• !I RECEIVED
Building Permit Application JUL 0 6 2018
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 Residential x
PERMIT APPLICATION FOR: Electrical
PROPOS.,ED IIVIPROVEME:NT;LOCAI'ION .-
s
Address: 5842 Travelers Way Fort Pierce FL 34982
Legal Description:
Property Tax ID#: 3410-503-0123-000-0 Lot No.
Site Plan Name: Block No.
Project Name: McKenzie
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION60F WORK
n
_.
Install a 120v 20amp dedicated GFCI circuit
C
CONST.RV ,N INFORMATION
_n.
d Additionalworkto e e Orme under this permit—check all appy:
11_HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
EjElectric 0 Plumbing Sprinklers ElGenerator E] Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 700.00 utilitiescnSewer Septic Building Height:
/LESS'
Name
„ np .CONTRACTOR
NameDorothy McKenzie Name: waiter nasi
Address:5842 Travelers Way Company: Sol electric Ilc
City: Fort Pierce State:FL Address: 5500 sw 43 terr
Zip Code: 34982 Fax: City: Fort Lauderdale State:FL
Phone No.772 466-1675 Zip Code: 33314 Fax:
E-Mail: Phone No. 754 423-4105
Fill in fee simple Title Holder on next page(if different E-Mail: wnasi72@yahoo.com
from the Owner listed above) State or County License: EC13008044
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL.CONSTRUCT(ON LIEN LAW INFORMAT--
DESIGN ER/ENGINEER:
TDESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Dorothy McKenzie Name:wafter nasi
Address:5842 Travelers Way Fort Pierce FL 34982 Address: 5842 Twelers Way
City: Fort Pierce State: City: FortLauderdale State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:5500 sw 43 terr 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
comoien,prig work or recording our Notice of Commencement.
1��_ ,,�zg2 Z,2�
Signature of Owner/Le a/Contractor as Agent torOWner Sig atur.,o' ontractor/License Holder
STATE OF
FL,OA
COUNTY OF T� STATE OF FLORIDAi446
COUNTY OF ¢¢��
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The for oing instrument was acknowledged before me The four oing instrument was acknowledged b ore me
this � day of C� 2 �y this 7day of 20 � by
Name of pers ing statement Name of person aking statement
Personally Known OR Produced Identification Personally Kno OR Produced Identification
Type of Ide ' lcati n Type of Id ificatio n
Prody ed Produce
Z jZ�"
r Qlw��11
(Signature f (Signatu - tate of Florida)
KATHRYN POCF(1211 KATHRYN POCK�
Commissio 0 �= ]SSION��49422 Commis qri v „•N GGO49eal
EXPIRES November 21,2020 �+gppv3 EXPIRES November 21,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17