HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED,
s r
Building Permit Application JAN 2 2 2019
Planning and Development Services
Building and Code Regulation Division Permitting D e p a rtm e n
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re clSbAlkie County, FL
PERMIT TYPE:Electric
Address: 5055 N Al Hwy#705 Ft. Pierce, FL 34949
Property Tax ID#: 1414-601-0143-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Install 120V 20AMP dedicated GFCI Circuit
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Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 700.00 Utilities: —Sewer —Septic Building Height:
Name Leona Schuyler Name:Walter Nasi
Address:5055 N Al#705 Company:Sol Electric LLC
City: Ft. Pierce State:_ Address:5500 SW 43rd Ter
Zip Code: 34949 Fax: City: Ft Lauderdale State:FL
Phone No.732-236-7707 Zip Code: 33314 Fax:
E-Mail: Phone No754-423-4105
Fill in fee simple Title Holder on next page(if different E-Mailwnasi72@bellsouth.net
from the Owner listed above) State or County License EC1 300 8044
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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: 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 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.
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Signature of Owner/Less4ie7tontractor agent for Owner Sign t Contractor/License Holder
STATE OF FLORIDASTATE OF FLORA
COUNTY OF Z4L?: CJ A k)o COUNTY OF �: gJP
The f ing instrumentwas acknowledge efore me The for oing instrume was acknowledg before me
this 71day of 20 by this day of 20t by
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Name of person making statement. Name of person making statement.
Personally Known 7,oduced Identification Personally Known ��- OR Produced Identification
Type of Identif' tin Type of Identif'
Produce Produce
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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