HomeMy WebLinkAbout159 River Palm Dr - Permit App'l 08-30-2018 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/30/2018 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X _
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 159 RIVER PALM DR
Legal Description: RIVERVIEW MANOR BLK D LOT 5 AND W 1/2 OF LOT 6 (OR 348-2457)
Property Tax ID#: 1408-703-0102-000-8 Lot No.5, 6
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
125 AMP, SINGLE PHASE SERVICE UPGRADE: SAME FOR SAME
CONSTRUCTION INFORMATION:
Additional work to be i)erformed under this permit—check all that apply:
11HVAC Gas Tank Gas Piping ❑Shutters ❑Windows/Doors
ZElectric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 2,400.00 UtiIitiestSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name LYNWOOD W HARMON JR Name: JOHN M.APPLEBEE
Address: 159 RIVER PALM DR Company: JAK, INC. d/b/a APPLEBEE ELECTRIC
City: FT PIERCE State: FIL Address: P. O. BOX 15
Zip Code: 34946 Fax: City: FT. PIERCE State: FL
Phone No. (772) 284-2046 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: APPLEBEEELECTRIC@BELLSOUTH.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.
SUPPLEMENTAL CONSTRUCTION LIED LAW I NF ORMATI N•;
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 folldwing 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
co ncing work or recording our Notice of Commence .
1AA
Signatur of Owner/Lesse / ontractor as Agent for Owner Signature o Contractor/Licen a older
STATE OF FLORIDA STA FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST.LUCIE
The for oing instru ent was acknowledged before me he forgoing instrument was acknowledged before me
5� s�-
thi� day of 2018 by this day of 2018 by
JOHN M. APPLEBEE JOHN M.APPLEBEE
Name 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
(Signature of Notary Public-State of Florida) (Signattire of Notary Public-State of Florida )
'!gal) MELISSA PARRAMORE MELISSA PARRAMORE
Commission No. :� ,► � Notary ommission No. GG 126946 -�+►' = NotaryPubiic-State of r=lori a
* •= Commission#GG 12b946 =.; •' Commission#GG 126946
My Comm.Expires Jul 23,2021 o�;= My Comm.Expires Jul 23,20 1
"'• ° .••''. Bonded through National Notary AS$P- -,cF, ,•' Bonded through National Notary As in. '
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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