HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \�\ �� Permit Number: \4m- d3 J a
RECEIVED
Building Permit Application
Planning and Development Services N O V 16 '201
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitunq
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residen la
PERMIT APPLICATION FOR: Electrical71
PROPOSED IMPROVEMENTLOCATION
Address: 903 Osceola Drive
Legal Description:
Property Tax ID#: 3409-411-0003-030-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRtPT.ION.QF.,VI/ORK. . `
Change out Main breaker, 3r, 32 circuit panel to new. Panel is located on the'exterior of house next to
meter can.
CONSTRUCTION INFORMATION:
Additional
� ,. . . .
work to e e orme un er t is permit-check a appy:
Gas Tank ❑
HVAC Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing O Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ ►OOC�.d d Utilities:ll Sewer E]Septic Building Height:
OWN.ERAESSEE: CONTRACTOR:
Name Lorette Christen Gouws Name: Joseph C Godfrey Jr
Address:903 Ocseola Drive Company: Godfrey Electric Inc
City: Fort Pierce State:FL Address: 1222 Omar Rd
Zip Code: 34982 Fax: City: west Palm Beach State:FL
Phone No. Zip Code: 33405 Fax: 561-833-9791
E-Mail:lorette210@yahoo.com Phone No. 561-833-3753
Fill in fee simple Title Holder on next page(if different E-Mail:j9odfreyjr@godfreyelectdc.com
from the Owner listed above) State or County License: EC-13007992
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SaUPPLEMENTAL CONST.,RUCTION LIEN LAW INFORMATION '
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:im Omar Rd 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 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 tl4e 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
commencin i g work or recording our Notice of Commencement.
e .
Sig natu a of 0 ess /C ractor as Agent for Owner Signatur of Contr ctor/ 'ceOre Holdpf
STATE OF FLOR A STATE OF FLO A &&Ll COUNTY OF �(�(�IYI IjC� COUNTYOF JM
The forgoing instrument was acknowledged before me The forgoing instru gent wa acknowledge before me
this_U_day of�IOwI'1��' ,2619_ by this day of 20f� by
N me of person maki tatement Na&e of person makingatement
Personally Known_�OR Produced Identification Personally Known 41 OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
o�pRY Pbq,- BARBARA D MOLINE ,�9S:arti , BARBARA D MW*
....... 9sion#GG 1667 *�
Commission No. * Commission No. # S"Jli)mWn11GG166287
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Expll�oP`oe BonGY11NBYAp�tN9py$ g ��`O `��e BOBEOQj�gy y S�YkBe
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17