HomeMy WebLinkAboutBuilding Permit Application 08/10/2018 9:28 Alli FAX 7724663765 APPLEBEE ELECTRIC 0001/0004
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/03/2018 Permit Number: � 0.p 0)602 09
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Building Permit Application
Planning and Development Services AUG 13 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34,982 Permitting Department
Phone:(772)462-1553 Fax: (772)462-1578 Commercial X Re§M.Mvi y, FL
PERMIT APPLICATION FOR: Electrical
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Address: 4190 SELVITZ RD.
Legal description: 32 35 40 N 600 FT OF S 653.50 FT OF E 655 FT OF W 705 FT OF SW 1/4 OF NW 114-LESS N 200 FT...
Property Tax ID#; 2432-233-0002-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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INSTALL 60 AMP SINGLE PHASE UNDERGROUND ELECTRICAL SERVICE FOR FLAG POLE
LIGHTING.
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itiona wor to pnrrormed un er is permit-c ec a appy:
Gas Piping ^Shutters Windows/Doors
HVAC Gas Tank ❑
❑✓ Electric ❑Plumbing ❑Sprinklers ❑Generator ❑Roof Roofpitch
Total Sq.Ft of Construction: SFt.of First Floor: __--
Cast of Construction:$ 2,300.00 Utilities: Sewer❑Septic Building Height:
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Name K AND M PROPERTIES OF FLA LLC Name: JOHN M.APPLEBEE
Address..7228C WESTPORT PL Company:Y• JAK, INC,d/b/a APPLEBEE ELECTRIC
City: WEST PALM BEACH State- FL Address: P.O-BOX 15
Zip Code: 33413 Fax: City: FT-PIERCE State: FL
Phone No.(561)844-9994 Zip Code. 34954-0015 Fax: (772)466-3765
E-Mail: Phone No. (772)'466-7930
Fill in fee simple Title Holder on next page(if different E-Mail: APPLESEEELECTRIC@BELLSOLITH.NET
from the Owner listed above) State or County License: EC#0002956
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
08/10/2018 9:29 A31: FAX 7724663765 APPLEBEE ELECTRIC 0002/0004
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P:PLE�MENI"AL:'CONSTR�U- F
DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: 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
coolffmnicing work or recording our otice of Commen t.
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Si nature ?Owner/Lesse Co tractor as Agent for OwnerSi=OF
f Contractor/L' a Holder
S F FLORIDA FLORIDA
COUNTY OF ;;r unix COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me The for5oing instrument was acknowledged before me
s�
thi �day of��2018 by is 3L day of CkiA_gM k-�_ 2018 by
JOHN M.APPLEBEE JOHN M.APPLEBEE
Nam.,of person making statement Name of person making statement
Personally Known._._.X . OR Produced Identification Personally Known X OR Produced identification
Type of Identification Produced Type of Identification Produced
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•:.RA' t MELISSA PARRAMORE
MI55A PAARAMORE NotaryPtbfc—Stateof
Florida
0NotaryPublic-5[ateofFlCoinml9slon s GG 12696
Comm scion GG12fi92 M Comm.Expires 123.2021
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(Signat re of Notary Public-Stat of 2) BOrmthroughNational Nwary ig ture of Notary Public- of 5mb
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Commission No. GG126w Commission No. GGimmo
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17