HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '�'
Date: September 24,2018 Permit Num ea / ' 0 - O5 (li v
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Building Permit Applicatio SEP 2 5 2018 '
Planning and Development Services
Permitting
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Building and Code Regulation Division a e r m i tti i;ci r i r j ti; l@
2300 Virginia Avenue,Fort Pierce FL 34982g
Phone: (772)462-1553 Fax: (772)462-1578 Commercial es.ldle .6 ie GOUrl y, FL
PERMIT APPLICATION FOR: Electrical :IEl
PIR'OPOSED IMP-O'U'EM.ENT LOCATION 2 4' ,
Address: 3917 Shoreside Drive
i
Legal Description: Tarpon Flats Subdivision(PB 69-27)Lot 6(OR 3942-2070) 'I
Property Tax ID#: 1423-566-0009-0004 Lot No.6
Site Plan Name: Tarpon Flats Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
-DETAILED DESCRIPTION QF WORK. "
Install electrical wiring for boat lift and (9) pier lights. p -0•- -/- ) i-c-72- p r rY) i-1
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CONST UCTiON'lN°PO MATlO .
Additional work to'b erformed under this permit—chec�C ll- apply.
HVAC Gas Tank Gas Piping Shutters I�Windows/Doors
ElElectric ❑ Plumbing SprinklersEll Generator El Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor: ,
Cost of Construction:$ 2,300.00 ' Utilities:I'Sewer Septic Building Height: . '
OWNER,/LESSEEK 5 CONTRA O ' ' .E.. v_
Name Thomas G.and Marie Juliano Name: Daniel S Richmond
Addr. ,. ,917 Shotbside Drive •_,f; Company: White Electric
Cit Hutchinson Island l State:FL Address:`645-3rd Place-°`•-°" •''"""°"
Zip`Code: 34947. • Fax: City Vero.Beach State FL
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Phone No:,.772.696 2009 ,..,,.:..,,, Zip Code: 32962 • '' •'Fax: 772.562.1410
E_maiktjuli@outlook.com Phone.NOo,772,567,.26.4,2,,..•.....,�,.,.•..4-t
Fill in fee simple Title Holder on next page(if different E-Mail: info@whiteelectricvero.com
from the Owner listed above) State or County License: EC 13002005 Cerl#:22782
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i
SUPPLEMENTAL CONSTRUCTION LIEN LAW IN ORMATION�
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
commencing work or recording your Notice of Commencement.
lE3fe,J,J12 j‘77-‘7Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License H
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5-N iAY) PUer COUNTY OF I ffrJA , vtr-
The fonrao-ing instrument was acknowledged before me The for ing instrument ,bras a nowledge before me
this 243'1 day of kryte,(M,r ,20 by this 2/ ay of (9'.�'(° (�� �;20)K by
S • P.4 tbl,t i au/via s .P.4eltivtad
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
LLU22
(Signature of Notaryaryy Public-li_ Q
State of f FfrLAJ
da) (Signature of Notary Public-p State of Florida)
Commission No&C-/�oQ /f (Seal) Commission No.(16 a 1-1- (Seal)
„...;';Z,' ., MAUREEN DI MARIA
7 • • ,i•". si-\;f.'. Notary Public—State of Florida
0•YYv;;;-. MAUREEN LA MARIA I • ; `l:•€ Comm'ssion#Gci 1b6984
s?• •"'_ .t. pyp�is-State:4u "1' v:�y Comm xi: 1, 2
REVIEWS F ��� : '; �►; F?fi�3ion#Gt� IOR PLANS VEGETATION 'A if'Raammu t • r • , I
CO ''� .i 'REktkEt4xpiresAprfb iiu' REVIEW REVIEW ALNWV__ — 41§141 =s
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DATE liOntlett through Naaoral NolaryAssn.
RECEIVED
DATE
COMPLETED
Rev.8/2/17