HomeMy WebLinkAboutBuilding Permit application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C�
Date: 9-4-2018 Permit Number:
I Jk-_-1 I_ R
Building Permit Application 11")?
Planning and Development Services Sr 49'De0
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 a
PROPOSED IMPROVEMENT LOCATION:
Address: 3318 ORANGE AVE - LOT#26
Legal Description: 8 35 40 PART OF SE 1/4 OF NW 1/4 MPDAF: FROM INT W L1 ANGLE RD AND NL1 OF ORANGE AVE
AS SHOWN IN PL BK 7-12 RUN W ON N L1 ORANGE AVE
Property Tax ID#: 2408-243-0003-000-8 Lot No. 26
Site Plan Name: Block No.
Project Name:_
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
RESUPPORT EXISTING ELECTRICAL METER RACKS
CONSTRUCTION INFORMATION:
Additional work to be erformed under t ispermit—check all appy:
1-1 HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
✓❑Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 950.00 Utilities: Sewer El Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name C/O RIVERSTONE COMMUNITIES _ Name: JEFFREY R. WAITE
Address: 6400 TELEGRAPH RD, STE 200 Company: INFINITY ELECTRIC CO., INC.
City: RI onMFIFI r)TowNSHiP State: MI Address: 630 TALL PINES RD
Zip Code: 48301 Fax: City: HAVERHILL State:FL
Phone No. Zip Code: 33415 Fax: 561-588-3805
E-Mail: Phone No. 561-662-9299
Fill in fee simple Title Holder on next page(if different E-Mail: INFINITYELECTRIC@BELLSOUTH.NET
from the Owner listed above) State or County License: EC13005456
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: xNot 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
commencing work or recording our Notice of Commencement.
1 17
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Sig t re of wrier essee/Contractor as Agent for Owner Sig t of n racto License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_41h day of September 20_1$ by this Ath day of SPptemb r 20_18 by
TEFFREY R.WAITE JEFFREY R. WAITE
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 Type of Identification
Produced Produced
44M�z 1_ezt_�n�
(Signature of Nota ublic-State of Florida) (Signature of Notary P lic-State of Florida)
...
CommissKEVIN JUSTWFal) Commissio KEY-LN JUST
State
o onda-Notary Public =� tete of Florida-Nota7pbli,,Commission GG 249681 Commission a GG 2
My Commission Expires , Kaa M m
Com '
21 16.2022ugust 16, 2022
REVIE PERVISOR PLANS VEG GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17