HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � yk Permit Number:
RECEIVED
• FEB 12 20119
Building Permit Application
Planning and Development Services ST. Lucie count/, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT TYPE:ELECTRICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 11711 S INDIAN RIVER DR
Property Tax ID#: 3532-413-0005-000-6 Lot No.
Site Plan Name: Block No.
Project Name: CHRISTOPHER KOEHLER
DETAILED DESCRIPTION OF WORK:
SUPPLY ELECTRICAL FOR BOATLIFT(SEE 1810-0356)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
X Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 800.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name CHRISTOPHER KOEHLER Name:RONALD KINDEL
Address:11711 S INDIAN RIVER DR Company:RK ELECTRIC LLC
City: JENSEN BEACH State:_ Address: 1537 SW LEXINGTON DR
Zip Code: 34957 Fax: City: PORT ST LUCIE State:FL
Phone No.321-443-9045 Zip Code: 34953 - Fax:
E-Mail:chdstopher.koehler@hyatt.com Phone No 772-344-9155
Fill in fee simple Title Holder on next page(if different E-Mail RKELECTRICFL@GMAIL.COM
from the Owner listed above) State or County License EC13007108
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION':
DESIGNER/ENGINEER: x�Not Applicable MORTGAGE COMPANY: a�Not Applicable
Name: Name:
Address: Address:
City: State.- City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: aC 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 authorise 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.
Signature of Owner/Lessee%/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S*, COUNTY OF S; �-.
The forgoing instrument was acknowledge before me The forgoing rostrum nt was acknowledged before me
this 121• day of Yt' ,20 by this \ .dayof�� .2011 by
Name of person making statement. Name of person making stater►)ent.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 4 l,. Produced_ `, L
(Signature of Notary P r1 -
AON
MARIE
COMtAt$S #GG 022023 i (Signature of „. !. 0 T% ESmbar2020 , : 2023Commission NO. > s d ;�` G1 :Qa�Pub}t�Ud� dtflr� COmmISSiOn N OMMI$SION# �0 10
:Q Notary ES:Dacemt ��}r�
goadadT +,Fo;f;oPc Bonded IbMNotmPuRrUndAwrik:rs
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
1ev.9/26/18