HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLE'TED FOR APPLICATION TO BE ACCEPTED
l-\r+n.UdLC.Permit Number:
Burilding Permit Application
P I o n n i n g o n d Dev elopm e nt Se rvi ce s
Building and Code Regulotion Division
2j00 Virginia Avenue, Fort f>ierce FL 34982
Phone: (172\ 462-L553 f:ax (772\ 462-1578 Commercial Residentia I xx
i pEnvrr APPLTcATIoN FoR:Electrical i
lPROPOSED IM PROVEM ENT LOCATION :
Address: 142 SE Lucero Dr Port St Lucie, Fl 34983
loo:l l-,tp<rri^tl^^. River Park
Property Tax lD #:
Site Plan Name:
341 9-550-01 29-000-5 Lot No.6
Block No.
Prolect Name:
Setbacks Front Back:Rioht (idc.Left Side:
l
ne\^/ AC
CONSTRUCTIIf, N I N FORMATION :
itional worl< to ormed under rs perml a p ply:
T
V
HVAC
E I e ctric
bas I anK
Plumbing
-l^lbas Hrprng Sh utte rs Windows/Doors
tr sprinkters l_l G"r,"r.to,.l_l noot I] Roorpitcr
Total Sq. Ft of Construction:\fl Ft nt Frrat Flnnr'-Y '''
Cost of Construction: S 16:t9 00 Utilities: l-lr"*.rr. E t"*Building Height:
COlrlTt{ACTOR:
Name: Kent Blosser
Address: 142 SE= Lucero Comoanv: Blosser Electric
City: Port St Lucie State:Address: PO Box 7305
ZiP Code: 34983 Fax:City: Port St Lucie
p hone 116. 708-323-5498 7in caAo. 34985 Fa x:
5-1y r11. johnsondaleb@gmail.com phone 116. 772-337-0055
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail : nrblosser@gmail.com
I
State or Countv License: EC13001570
DETAILED DESCRIPTION OF WORK:
Replace AHU & condenser electric for
OWN ER/LESSEE:
N3ms Dale & Piltricia Johnson
lf value of construction is 52500 or more, a RECORDED Notice of Commencernent is required.
trl5tate:r L
SU PPLEM EI\TAL COI\STR U CTION LI E I\J LAW I N FO R MATI ON :
FEE SIMPLE TITLE HOLDER: _ Not Applicabte
Name:
AddfeSS:po Box 7305
BONDING COMPANY: _Not Applicable
DESIGNER/ENGtNEER:
N a m e: Date & patricia Johnson
_ Not Applicable MORTGAGE COMPANY:
Name: Kenr Btosser
_ Not Applicable
Ad d f gSS: 142 SE Lucero Dr pod Sr Lucie, Ft 34983 AddfeSS: 142 sE Lucero
City: Porr sr rucre State:City: Porr st Lucie State:Phone
Signatu of Owner/ Lessee/Contractor as ngent for. O*ner.Signat
STATE OF FLORIDA
COUNTY Qprroroa
5t' Lucie Countv makes n th.t ::,glllting^a permit wil permit hotder to build the subiect structurewhich is in conflict with a me Owners lrsiociation rule d covehjnts that may restrict cjr prohibit suchstructure Please consult own-ers Assoiiatio;;;;';e; ioiin-y'l"rtrictions which may apply.
In consideration of the granting of this requested,pernrit, I do hereby agree that lwill, in all respects, perform the workin accordance with the approved prans, the Frorida Building codes and st. Lucie countv Amendments.
of Contractor/icense Holder
STATE OF FLORIDA
COUNTY OF Fronda
The forgoing instrument was acknowledged betfore me The forgoing instrument was acknowledged before methis 25th day of .r,ry zo i8 bv this 2srh day of Jrrv zo i8 bv
Name of person making statement
Personally Known xx OR produced ldentification
Type of ldentification
Prod u ced
Name of person making statement
Personally Known xx OR produced ldentification
Type of ldentification
Produced
MANGROVE
REVIEW
Rev.8/2117
(Signature of Notary
Commission No
of Ff6ttuErF nELLEX
Commissidn # GG 68535
My Comrnission Exoires
reortlEPV o I ,20,1
(Signatu re of NotairtrT.J
sion #'GG 5853b
My Commisglorr Lxorres
Jebruorv{tRQHoz r
REVIEWS FRONT
COU NTER
ZONING SUPEI]VISOR
REVIEW I NTVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW