HomeMy WebLinkAboutBuilding Permit ApplicationALL APPL1,CABLE U14FO MUST BE C061PLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application
Pi'anning and
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23961 '-.f;rg.rij'cr Av Fort Pierce 34932
Plione: I772,, 46-21-1553 Fax-- 17,72) 462-1578 CavnrnercN.al Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION-.
Adds els: 1 s30 S Indion Rer DR Fort PEerQel, FL 34982
Legal Description'. 6.S.. HARRIS' S.,'D BLK 3 -LOTS -14.5,6 AND 7 AND 415 FT OF 1-0-1 S '516,17 AND 18
- --- ------
AND N 86 F-3 OF LOTS 19 AND 20 (,190 A) (OR 1141 -'902: -12T2 -'i216, 3966-1349)
FlropeMTax ILS #, 3532-503*D29-0DD-6 Lot N'c.
Site Plain Hame: Block, No.
Projem. Name:
Se—backs Frcrn� B a &.44 - 'Ugtt S i de Let Wide.
DETXLED DESCRIPTION OF WORK:
Replace disconnect with 200amp main tyreak-er panel_ Imps-ove ground to code.
CONSTRUCTION INFORMATION:
Add[tjonal workzo be e -formed under -.1lis pe m=ll - check a,,": a-p�y:
HVGas Tank LIG-as PiuiFlg t5hutters �Wir:Clcw
AC
,-`DcoTs
Electric F_Plurribing �Sprin?ler Fe 1�ocf F �tm-
nerBto.-
Toy al Sq. Ft of Congtruction-_ Sq- 11F t - o f 11 i r s t Fu, c o r. -
11.
Cost of Construction: S U til iti e S: r] Sewer S 2 ptic Buil ding- H ei ght:
OWNER/LESSEE:
CONTRACTOR:
Name James L SmAh Ar-geliGa. C Smith
Name: Fjars:3gan
-Michae!
compary First Quality, Eleiatftal Service
1111 i3 S Indian 6� ,er Dr
City Fort Pi!aToe- State— FL
Addre� , 7336 SE Ocean Blvd
C1 ,: Stuart FL
Zip cod, 34982 Fax:
Phone No. 772--' 28xj9 916
Zip C:ode: 34996 Fay::
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Fill'i in fee simpEeTitle Holder on next page (if different
E -Mail:
State or Coumly Licpense: Er- 13002096
grom the 0%rvner fisted al)cvve)
If value of construction ;is S25DOarimcive, a RECORDED Notice of:CGmr-nencernerkt:is required.
SUPPLEMENTAL CONSTRUCTION LIES] LAW INFORMATION,
DESIGNERIENGINEER- Not Applicable
Name:
MORTGAGE COMPANY. Not Applicable
Name:
Address:
city:State:
Zip: Phone -
Address:
City: State:
Zip, Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Narne:
BONDING COMPANY: Not Applicable
Name,
Address:
Address:
City:
C14.
zip: Phone:
Zip: Rhone.
OWNER/ CONTRACTOR AFFIDVIT: Application:s hereby made to obtain a permit to do the work and installation as indicated.
I certifyr that no work or !T)staflatron has c4ornmenced prior to the issuanze of a permit.
St. Luce ' Culinmakes o representation that is granting a perm.it w,'permit 11 authorize the p�rt holder tl�j build the subject structure
I Tlr
which is in con. 0 with any applicable Name Owners Assndiatiari rulues, bylaviso r and covenants €hat m8y restrctt or prohibit such
structure- Please consult with your :House Owners Association and review your deed for any restrict cns which r7lay apply.
In considerations of the granting of this requested pp.rrnit, I dG hereby agree that I will, m all respects, pErforrn the work
in a( corda nre with the approved plans, the F[oridj >'�ui ld i ng Code_t-, and St- Lucie County Arnendrnents_
The following building perrnit appiicatIons are exempt from undergomg a full concurrency review: m0rrl aftt,,Ons,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non -residen Ilia I 'Ise
WARNING TO OWNER: Yong faillure 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 jo bsite
before the first inspection. if you intend to obtainfinancing, consult with lender or an attorney before
commencing work or recording your Notice of Commence m ent.
Rev. 8/2/17
Signature if Ownerl Less/Contractor as Agent for 0,.vner
Signature if Ccritra`ct0r/UrEense 9folder
STATE OF FLORIDA .
STATE OF FLORIDA
COUNTY OF Ma,(±Z)0
COUNTY OF
The fo-rgoing instrument was acknowledged before me
Tose forgoing instrument was acknovJedged before me
this0
day Of JLAj, 20J t by
this (07��ay of J, U t L'4. 2by
Ap
ft ..
Na me o f person ma4ig staterr ent
Name of per:on making statementJ
ReTscn8lly Known OR Produced Identifica,
Personae Known OR Produced Identificalion
Type of Identification
TYpe of ]dentification
Produced 9//
(Sig nature of NotYak4&Vida
lorida GG 119M
csignatuxe&N'Otary ublic-S" ROWAINE B GROME
Notary public - State of
Commission No- MY Comm- Expires Nov
8 2018 fis_e�iion No. Jum3,2e0eal)
h'
V
F 0� Commission # FF 140
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REVIEWS
FRONT
ZONMG
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
RE%q EW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17