HomeMy WebLinkAboutBuilding Permit Application AUG/21/2019/WED 10:56 AM ACCH INS AGENCY FAX No, 7724085501 P, 002/003
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: b ' .0�1 �'1 Permit Number: q v OV 2—,--,
41169
- - - - -- Building Permit Application peSt��in9p
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Planning and Development Services
Building and Code Regulation Division Unt' nt
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial_ Residential_
PERMITTYPE; Electrical
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Address: 10044 S OCTAN DR 607
Property Tax ID#:4502-804-0047-000-2 Lot No,
Site Plan Name:A Belma Yurdakul Block No,
Project Name: A Belma Yurdakul i
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Replace existing lighting and rewire as needed
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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:$ 1700.00 Utilities: —Sewer _Septic Building Height:
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NameA Selma Yurdakul _ __ Name:Robert Thompson
Address:PQ Box 1405 Company:R Thompson Electric
City: Palm City State: Address:439 SE Cork Rd
Zip Code: 34991 Fax: City: PSI-
State:EI
Phone No.772-5294695 Zip Code: 349$4 pax: 772-408-5501
E-Mail: Phone No 772-203-1756
Fill in fee simple Title Holder on next page(if different E-Mail rthompsonelectric§yahoo.com
from the owner listed above) State or County license EC13007306
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.
AUG/21/2019/WED 11 : 16 AM ACCH INS AGENCY FAX No, 7724085501 P, 003/004
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DESIGNER/ENGINEER: T Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Add ress:
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 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 accessary 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 SE RECOROEII) AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION- W YOU INTEND TO OBTAIN FINANCING, CONSULT
VMH YOUR USOWM OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE—IW-.COMMENCEMENT."
SldnatdFe o_0wrier/Lessee/Contractort s Agent for Owner Signatdre of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA `
COUNTY OF COUNTY OF � UCA
The forgoing instru ent was acknowledged before me The for Ting instrument was acknowledged before me
this day of 4'V& 20� by this day of 20 1 by
�n be r'g ,°tet a5 X)n1
Name of person making statement. Name of person making statement.statement.
Personally Known U OR Produced entification Personally Known `F' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(5ignatu(e of Notary Public-State of tori of Notary Public-Sta
e{ Notary Public Stare f 0r
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i Moliesa L Buttert ld �� �, Notary Public State of Floft z
GOmmISSIOn Np- ti1y Comnw!on QG C2opsmi n No.t,a f1(^`� ( >gAI sa L Butterfield
FL my Commimlon GG 34206
do Expires O2)14/2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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