HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: t' 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 x Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMR.ROUfMENT LOCATION: r
Address: 6047 Santa Margarito Dr #CATV Fort Pierce 34951
Legal Description: Portofino Shores(PB 43-6)Water Management Tract 3 (2.357 AC) (as per plat dedication dated 10.29.03)
Property Tax ID#: 1312-501-0008-000-5 Lot No.
Site Plan Name: SP- Santa Margarito Dr#CATV Block No.
Project Name: Comcast Power Supply
Setbacks Front Back: Right Side Left Side:
DETAILED'DESC;RIPTIQN OF;WORK
�.
Install new Comcast power supply cabinet located on the south side of Santa Margarito Dr east of
Splendido Way
CONSTRUCTION INFORMATION
Additional wor to be performed under this permit—c he a appy:
HVAC Gas Tank F7GasPiping OGenerator
Shutters Windows/Doors
21 Electric Plumbing Sprinklers Roof Roof pitch
Total Sq. Ft of Construction: 8 S Ft. of First Floor:
Cost of Construction:$ 822 Utilit es:Sewer OSeptic Building Height:
01NNER/LESSEE CO NTRACTO:R
= -
Name Anthony SDrincsteel Name: Gary J Gifford
Address. 3960 RCA Blvd, Ste 6002 Company: Gary J Gifford, Inc.
City: Palm Beach Gardens state:FL Address: 350 SW Linden St
Zip Code: 33410 Fax: City: Stuart State:FL
Phone No.561-804-0973 Zip Code: 34997 Fax: 772-219-0146
E-Mail:anthony_springsteel@cable.comcast.com Phone No. 772-286-0954
Fill in fee simple Title Holder on next page(if different E-Mail: giffelec@comcast.net
from the Owner listed above) State or County License: EC13001574
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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.
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 yourdeed 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
commencinavrork or recording our Notice of Commencement:
Signature of Owner/ s /Contr4a6tor as Agent for'Owner Signature of Contra or/ ' erase Walder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Martin COUNTY OF Martin
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 19th day of December ,201L by this is_day of necemher 20_g by
GaryJ Gifford GaryJ Gifford
Name of person making statement Name of person making statement
Personally Known X OR Produced Identification Personally Known X ORP roduced Identification
Type-of Identification Type of Identification
Produced Produced
(Signature of No �R ic- A_ #tElQ6Ai df Florida (Signature of Notar Public=S a F o i a
Susar►_G Carrasquilto
P Notary Pubifc State of FF,��wr11dd��
Commission No. Mycommisai_W7510 Commission N `' � CarrasquiVbeal)
• a>tie o 1012512 as My Commission GG 027810
p n Expires 1012512020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17