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HomeMy WebLinkAboutELECTRIC - RESIDENTIAL All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: I�CS`�'d531 _•� �: ��+�� �'�_ "��j�� RECEIVED J . Building Permit,Application SEP 5 2018 Planning and Development Services Building and Code Regulation Division ST. L-dsie Eounty, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential t PERMIT APPLICATION FOR: PRO OSED IN Rt?1/EM�NT LC•}CATIC�N: Address:. IsLt S K) WO Q Legal Description: Property Tax ID#: a�O d�33–d ad ��-� Lot No. Site Plan Name: Block No. Project Name: 'P W H(A 9 Rf C" rG Setbacks Front Back: . Right Side: Left Side: • =111MON 12 3 ✓0' �- G�$'Ila U3 s '-� f 2-3 .a-�cr P CON�TRU TION INFORMATION: itiona wor to a pe. Orme un er t is permit–c ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors VIE I ectric —Plumbing —Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ SO Utilities: —Sewer —Septic Building Height: 0 NW IR/LWN E: CONTRA O Name w i R' ��'�/� Name: .R6 0044) Address: 6-;111 3_ 1VA1 18A slt Company: E 4;VF �lL City: 6 State: Address: y2--(Q Zip Code: City: U P State:�L Phone No. g– Zip Code: 33 S Y Fax: E-Mail: WbvhQ i' O CO Phone No V�6/ 020L3 '©ll Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 00 330 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. _ SUP LEM ENT I.CQNST� U:CTIflN U--� LAW I �I"CiRMA Q; ; 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 thepermit holder to build the subject structure which is in corfflict 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. Signature of Own e ssee/Contractor as Agent for Owner elgature of C tractor/License Holder STATE OF FLORIDA STATE OF FLORIDA , COUNTY OF 4, k. LJ«@ COUNTY OF The forgoing instrument was acknowledge before me The for ging inst ument was acknowledg before me thisWr , day of ��p'� 20Aa by thisa� dayof�V 20� by Name of person making statement. Name of person making stat ment. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced L (Signature of Notary blic-State of Flo ; 1 (Si nature MpR1EG1vEPix, g p tai Q8`j "0r•;o'y�.• MISSION#GGtdILSUSIOtd#G 1 g'� `' a Commission No. 2 7 (� Ipecemberl6, 04 Commissiorti S g: ecembe' /S publlcUnde'i'r;n;a l,l 'N:• °: dYhruNofaNpubFIC, ,ii.�. 'O gonded'ThN Notary oo:F:�P: gonde REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED. DATE . COMPLETED ev.