HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/11/2019 Permit Number: / // ���4•
RECEIVE[
BuildingPermit A LicaLRE
pPJUN 2 2019Planning and Development Services
Building and Code.Regulation Division itting D e p a rtm e t
2300 Virginia Avenue,Fort Pierce FL 34982 Luc i e CO u n t
Phone:(772)462-1553 Fax: (772)462-1578 Commercial x Re Yr F
PERMIT TYPE:Electrical
=FROP�SEDtMPROt%EMEIVT LOCATiaN 'i� ' 3 �� �A=
Address: 10820 S Ocean Drive,Jensen Beach,FL.34957
Property Tax ID#: 4511-501-0001-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Holiday Out
to s
DETAILED DECRIRTION C?F U�ORK "y
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Installing 314"PVC Schedule 40 conduit underground for future lighting and low voltage controls.
�CQNSTRUGT(tON�NEORMATION',� n � _
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:$ 2000 Utilities: _Sewer Septic Building Height:
OWNE'R�LESSt E � CQNTRACTOR ;°
Name Holiday Out At St Lucie Name;Brian Stott
Address:10725 S Ocean Drive Company:Stott Brothers Electric
City: Jensen Beach State:_ Address:385 NE Glentrty Avenue
Zip Code: 34957 Fax: City: Port St Lucie State:FL
Phone No. Zip Code: 34983 Fax:
E-Mail: Phone No772-408-4911
Fill in fee simple Title Holder on next page f if different E-Mail stottbrotherselectric@gmail.com
from the Owner listed above) State or County License ER1 3015522
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.
$l)PKEMENTAI��CINST#tU T1t k 'Ihf L'A` tNFORMATOW ` g
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: i 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.
1 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 Horne 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 JOB SITE BEFORE THE FiRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR 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 COUNTY OF
The for oing instrument was acknowledged before me The forg�Qoing instrument was acknowledged before me
this day of J—V APL 201�by this f'day of ..I VfQ• 20 by
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Name of person making statement. Name of person making statement.
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of identification Type of Ide!gification y
Produced 'N L" xb -2au Produced
David Singh David Singh
(Signature of Notary Public-State of NOTARY PUBLIC ((Signature of Notary Public-State of Flor o NOTARY PLi l
r � STATE OF FLOR 0 STATE F FL OA
Commission No. M3 tc 3 f Co=*GG0639 2Commission No.6;6 ®C9�31 Coma#
Expires 112812 21 Expires 112812 21
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.217119