HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLEINFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: Di I[7-El"l re Permit Number: 18Oq—D (/(5
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RECEIVED
Building Permit Application SEP 2 8 1018
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION :u-t-I`CirqDom, '
Address: 2705 quail rd
Legal Description: 20 35 40 FROM NE COR OF NE 1/4 OF NE 1/4 OF SW 1/4 RUN W 200 FT, TH S'19
TH S 185 FT, TH W 185 FT, TH S 78.15 FT, TH E 200 FT, TH N 263.15 FT TO POB
Property Tax ID#: 2420-311-0003-010-5 Lot No.
Site Plan Name: Block No.
Project Name: W/H
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION';OF WORK , '
Run 1/2" pvc conduit with (3)#10 THHN wire around house from panel to garage for water heater.
Install disconnect and 25 amp breaker in panel.Existing circuit does not meet code requirements.
CONSTRUCTION INFORMATION
Additional work to be erformed under this permit—check all:ha)apply:
UHVAC LI Gas Tank 1Gas Piping Shutters 0 Windows/Doors
Electric El Plumbing Sprinklers I I Generator Li Roof Roof pitch
Total Sq. Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 675 Utilities: Sewer OSeptic Building Height:
.OWNER/LESSEE: - r:' , :: '-''-- - CONTRACTOR:
Name Christene Green Name: William Collis`
Address:2705 Quail rd Company: Collis electric and air conditioning Ilc
fort pierce n 2/13 sw tondura rd
City: State:TI Address:
Zip Code: 34981 Fax: City: port saint lucie State:fl
Phone No. Zip Code: 34953 Fax:
E-Mail: Phone No. 7723706095
Fill in fee simple Title Holder on next page(if different E-Mail: collisC89Ca?gmaIl.COm
from the Owner listed above) State or County License: EC-13002/7/
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN,LAW INFORMATION -I
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 j
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR A FFIDVIT: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 your Notice of Commencement.
1
-1/ •• 0 16- €. f /--. ---a. .'• ‘— te>"-92, ,
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDAc, l STATE OF FLORIDA L �
COUNTY OF `SF.Lore COUNTY OF c
The forgoing instrument was acknowledged before me The forgoing instrument vyJas acknowledged before me
thisgb day of ,5e 1 ,20 Jo by this 8 day of em/&l ,20 /S by
L'1 k' urn CANS 0)c4 vi CQ l I s!
Name of person making statement Name of person making statement i
Personally Known OR Produced Identification V' Personally Known OR Produced Identification i,
Type of identification Type of identification
Produced pi...-G4go-x)i-57-/65-D Produced, -- Cao- gal-37- f' .5'-c>
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(Signature of Notary Public-Stat o .o-••. '• _ature of Notary Public-State of Florida ••;:4:;r•�
;•�),zrap�;, FERNANDO BETANCOI R .=p'•., FERNA Di BETANCOURT
� .� Notar Pu li State of Florid
G:)( tVotar P blit-State of Ma
a / /�� /c�) rte/, �� y
Commission No. _.: eai) y4ormission No.l-Z�(92/040 a'•a • F` Commi•sii 4GG 194040
Commission#GG 194 ( �..�Fov cL c• My Comm.Expires Mar 11 2022 • ''':•o�-*- My Comm.E�1 res Mar 11,20:
'"•'''Bonded through National Notar'Assn. il
"•• Bonded through N,i anal Notary As
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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