HomeMy WebLinkAboutBuilding Permit Application S
ALL APPLICABLE INFO MU:'T BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/12/2018 Permit Number: ' ® �
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
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Address: 3042 NW RADCLIFF WAY, PALM CITY, FL 34990
Legal Description: RIVERBEND (PB 67-36)-LOT 12 (OR 4122-2638)
Property Tax ID#: 4425-703-0017-000-7 Lot No.
Site Plan Name: Block No.
Project Name: JAMES COVEY
Setbacks Front Back: Right STde: Left Side:
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Supply and install a 100 amp sub panel.... Wire (2) boat lifts ..... Supply and install a 50 amp pedestal.
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COI�ISTRLICTICIIU INFORIVIATIQ[�i r '. k
Additional work toe nPrtprmea under this permit—check all appy:
11HVAC Ej Sas Tank Gas Pipirig Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers ElGenerator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2,000.00 Utilities:Sewer D Septic Building Height:
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Name JAMES P COVEY AND SHARON A COVEY Name: GARETf GUIDROZ
Address:3042 NW RADCLIFFE WAY Company: COMPLETE ELECTRIC INC
City: PALM CITY State:FL Address: 637 SEBASTIAN BLVD
Zip Code:'34990 Fax: City: SEBSTIAN State:FL
Phone No.772-453-5301 Zip Code: 32958 Fax: 772-388-2411
E-Mail:jim@jcoveylaw.com Phone No. 772-388-0533
Fill in fee simple Title Holder on next page(if different E-Mail: mskelley@completeelectricinc.com
from the Owner listed above) State or County License: EC0001911
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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.
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.
Signature of Owner/Lessee/Contractor as Agent 0 Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFINDIAN RIVER COUNTY OF INDIAN RIVER
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 12 day of SEPTEMBER ,20AS by this 12 day of SEPTEMBER 20M by
GARETT GUIDROZ GARETT GUIDROZ
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
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(Signature of Not ry ubli (Signature of Notary b -
14Rr?ry Nolfa`ryg P`u}blic State of Florida _0v°oI Notary Public State of Florida
Commission No. FF901564
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ommission No. FF901564 .�' �. Hatfield
c oa MY Commission FF 901564 v Aga M o ion FF 901564
o;tom Lxpirtfs 09/19/2019 �o�no Expires 09/19/2019
I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17