HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: Permit Number: / 17'
e
RECEIVE
Building Permit Application NOV 212018
Planning and Development Services
Building and Code Regulation Division Permitting Departme
2300 Virginia Avenue,Fort Pierce FL 34982 t, Ducie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi
PERMIT APPLICATION FOR: Electrical El
PROPOSED IIVIPROVEIUIENTLQCAION 5b ' k
Address: 102 SE Bonita Ct
Legal Description: River park Unit 5 Block 52 Lot 1 (MAp 34/28S)
Property Tax ID#: 3419-540-0292-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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D"'ail SLED D CRLPTION QF WORK �'�
#z-,° _s,r/ks r..�"ter.. ,.iT..u.,. L. ,1.. _.•, ,... y?._....,, ac ..,&
SERVICE UP-GRADE / ® n 47-r+IN s—D m
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Additional work toe performed under this permit—crieck all appy:
❑HVAC Gas Tank []Gas Piping in _Shutters ❑Windows/Doors
R]Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 850 SFt.of First Floor:
Cost of Construction:$ �' L Utilities: Sewer Septic Building Height: 1
OWNER/,LESS � � a � �° £ CONTRACTO7R �
Name SAB Capital LLC Name: Glenn R Modica
Address:7024 17 th Ave Company: Phase 3 Electric
City: Brookyn State:NY Address: PO Box 8653
Zip Code: 11204 Fax: City: Port St Lucie State:FL
Phone No.772-3809011 Zip Code: 34985-8653 Fax:
E-Mail: Phone No. 772-971-7781
Fill in fee simple Title Holder on next page(if different E-Mail: phase3electric@att.net
from the Owner listed above) State or County License: EC 13007053
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION,UENLAIN fN,17
FORIVIATION �" k �3
DESIGNER/ENGINEER: x_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:PO Box 8653 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 our Notice of Commencement.
GGfiell
Signature of Owner/Lessee/Cont actor as Agent for Owner (gnat re of Contractor/License H Ider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF WC«
The forgoing instrument was acknowledged-before me The forgoing instrument was ackno ledged before me
this day of N) N'19� 20 by this L day of 20=by
Glenn R Modica Glenn R Modica
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type Ide cation Type of Ide 'fication
Produced Produced
'.T'W"'x
( gnature of Not y Public-State of Florida ) (Signature of Notary Public-State of FI ri
;"Ori TIAMARISSAALEXAND R
Commission No. 'Vr Commission No �( 1�—�J NotaryPubllc-StateofF ri
AUDREY 6 PHREY Commission 8 GG 242 0
MY COMMISSION#FF 174772 ? My Comm.Expires Oct 4, 0
�4 EXPIRES:March 6,2019 Bonded through National Nota As
�'•.. n.NM.rmy Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17