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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date. 10/29118 Permit Number: Building Permit Application Planning and Development Services ,Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 X Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 14099 Cancun Avenue Legal Description: Single Family Dewling Property Tax. I D #: 1306-501-0293-000-0 Site Plan Name: Project Name: Setbacks Front Back:_ DETAILED DESCRIPTION OF WORK: Right Side: Left Side: Install new 15 amp 120v wiring for Mini Split airconditioner. CONSTRUCTION INFORMATION: Itlona work toni orme -- er t is permit – c ❑ HVAC L_J Gas Tank ❑Gas Piping Electric Plumbing oSprinkiers Total Sq. Ft of Construction: – Cost of Construction: $ 550-00 OWNER/LESSEE: NameJohn Socha Arldrpgq-14099 Cancun Avenue ecK all rnar apply: LJ Shutters E] Generator SFt. of First Floor: — utilitiescnSewer 0Septic City: Ft. Pierce State:FL Zip Code: 34951 Fax: Phone No.5867038743 E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) CONTRACTOR: Name: 'Edward Russ Lot No._ Block No. IDWindows/Doors 11 Roof Roof pitch Building Height: Company: Blue Star Electric Address: _1 Q?, P64Y►'l0 v, City: Ft. Pierce State: FL Zip Code: 34951 Fax: Phone No. 7723605779 E -Mail: Bluestarolectricllc@gmail.com State or County License: ER1301560 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: AlamP. Address: City: Zip: Phone. FEE SIMPLE TITLE HOLDER: Name: Address: City: zip: Phone:_ x Not Applicable State: Not Applicable MORTGAGE COMPANY: Name: Address: Citi: Zip.. Phone: 'I,_ Not Applicable State: BONDING COMPANY: Not Applicable Name:_ Address: City;_ 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 sctrecnitpprle s tlary udr cstrict 6r pibit such trruue- PlasecosulthyouHomOwnerAssocaionndreview r de for any restrictions may 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 commencinglNork or recording our Notice of Commencement. ; of O Ger/ Les 2e/Contractor as Agent for Owner � Si STATE OF FLORIDA COUNTY OF (, The forgoing instrument vyas acknowledge before me this ay of, QG'� ©J f� 2Da by Name of person making statement Personally Known OR Produced Identification TypeIdentVi Vr� i en Produced !,�S (Signat e of Notary Public -State of Florida Commission No. & 0 r �`A Erich Daniel Krach NOTARY PUBLIC' STATE OF FLORID Comm# GG105925 STATE OF FLORIDA COUNTY OF '/Lige Holder St. , ��(f C The forging instrument u'�yf is acknowled before me this r-14ddy of sb 20! by J Name of person making statement �/ Personally Known OR Produced Identification /`- Type of Identific tion Produced ((G f r �— (Signatur of Notary Public- Stat of Florida )Crich Daniel Krach ���rZSY TARYPUBLIC Commission No. s STT TE OF FLORIDA 4 = Comm# GG105925 REVIEWS I FRONT COUNTER � R VIEW NING � SUPERVISREVIEWOR � REV W � VEGETATIREV1 WON SEREV EWLE MREVIEWVE DATE RECEIVED DATE COMPLETED Rev. 8/2/17