HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J• Permit Number: "RED
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Building Permit Ap p l i ati on
Planning and Development Services Permitting Department
and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial esl en Ia
PERMITTYPE:Electric
Address: 1600 NW Buttonbush Cir Palm City FL 34990
Property Tax ID#: 4426-840-0002-000-4 Lot No.
Site Plan Name: Stein Block No.
Project Name: Stein
91
Install 120 V 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:
NameAlfred Stein III Name:Walter Nasi
Address:1600 NW Buttonbush cir Company:Sol Electric LLC
City: Palm City State:_ Address:5500 SW 43rd Ter
Zip Code: 34990 Fax: City: Ft. Lauderdale State:FL
Phone No.772-260-5488 Zip Code: 33314 Fax:
E-Mail: Phone No 7554-423-4105
Fill in fee simple Title Holder on next page(if different E-Mailwnasi@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.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDPR OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature o caner Lessee/Co tractor as Agent for Owner Signa t of Contractor/License Holder
STAT OF FLO, / j\ STATE OF FLO�A
COUNTY OFi 0/66 COUNTY OF�j
Thefor *ng,nstrum t was acknowledg efore me The fing instrum t w s acknowled before me
this S may of 20by thisday of U 2 by
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Name of person making statement. Name of person making statement.
Personally Know oduced Identification .1111_� Personally Known'4 OR Produced Identification
Type of Iden ' ication Type of Id • ica io
Produe Produc
(Signature f r P IiE° t so q POCK�,K°"�Wle OT
(Signa re t Stutolunk o of Florida
My COMMI8St°r7'-,G C1a8422 KATHRYN PO KER
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Commissio o. °FR p �Seal)��y�°� Commission No. i ExR'res 11121/2
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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