HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ``• ��• �g Permit Number:
RECEIVED
Building Permit Application NOV 2 9 2018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Electrical
P,ROPQSED..IMPROVEMENT LOCATION:
Address: 7005 Maidstone Dr.Port St.Lucie,FL 34968
Legal Description:
Property Tax ID#: 3322-505-0126-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF.WORK:
Install 120 V 20 AMP dedicated GFCI circuit
CONSTRUCTION INFORMATION X
Additional work toe nertormed under this permit—c ec a appy:
HVAC 0 Gas.Tank FGas Piping _Shutters Q Windows/Doors
Electric ElPlumbing Sprinklers 12 Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 700.00 Utilities: Sewer 01 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name David Pickard Name: Walter Nasi
Address:7005 Maidstone Dr. Company: Sol Electric LLC
City: Port Saint Lucie State:FL Address: 5500 SW 43rd Terr.
Zip Code: 34986 Fax: City: Ft.Laudrdale State:FL
Phone No.772-201-3971 Zip Code: 33314 Fax:—
E-Mail: Phone No. 754-423-4105
Fill in fee simple Title Holder on next page(if different E-Mail: wnasi72@yahoo.com
from the Owner listed above) State or County License: EC 1300 8044
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION .
.�
DESIGNER/ENGINEER: _Not ApplicableMORTGAGE 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:5500 sw43rdTerr. 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.
_�/ ,F_,(�? k1,1 'A
Si ature of Owner/Le see Contractor as gent. or Signa r tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 61C.OW19 COUNTY OF
The for oing instrume t was cknowledged b ore me The forgying instrument wa_s 4cknowledgel,be�fore me
this I1 day of U 20 y this ,day of CEJ V 20�by
I-DA (fib BM64L
S
Name of person making statement 1 Name of person making statement
Personally Known OR Produced Identificationy Personally Known�Produced Identification
Type of Identification Type of Identificati
Produce Produced
( ignat c-Sta of Florida) (Signatqtg
ate of Florida)
Notary ublic State of Florid(Sea Commiblic State of Florida(S I)
Commi i� K/ITIJo F -v f-...KER N POCKER
My Commission GG 049422 ission GG 049422
OF ROExpires 11/21/2020 /21/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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