HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Electrical
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential X
Address: 9600 S. Ocean Drive, Unit ##1206, Jensen Beach, FL 34957
Property Tax ID #: 4502-620-0096-000-6
Site Plan Name:
Project Name: Engle
DETAILED DESCRIPTION OF WORK,
Electrical modifications for kitchen remodel.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical Gas Tank Gas Piping _ Shutters
Electric — Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1,500.00
OWNER/LESSEE:
Name Dave Engle
Address: 9600 S. Ocean Dr., Unit #1206
City: Jensen Beach State:
Zip Code: 34957 Fax:
Phone No.
E-Mail :
Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors
Roof Pitch
Utilities: `Sewer Septic Building Height:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: Michael Dale Ault
C-mmnnnv,Ault Bros, Inc. Electrical Contractor
AririPO Box 1528
City: Port Salerno State: FL
Zip Code: 34992 Fax: NIA
PhnnP N0772-283-5520
E-Mail aultbros@yahoo.com
State or County License ECO001693
If value of construction is $2500 or more, a RECORDED Notice of Lommencemenz is requireu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
-SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:
DESIGNS
Name:_
Address:
City:
Zip.
GINEER: Not Applicab
Pho
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
UWNER/ 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 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 112ECORn1InrG Ynim NnTirip nF rnmmFlurirmrW'i r
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY A 1/1
STATE OF FLORIDA
w � k1_1\
OF_._ _ _
COUNTY OF f
The forgoing instr ent wa acknowledged before me
The f�oyrgoing instru ent wa acknowledged before me
`�
.� �
thisQ-� day of .J J� 201� by
this L day of 20t l by
Name of person making statement.
Name of person making statement,
Personally Known OR Produced Identification
Personally Known X1, OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
V
a W 6VWMU'�
7 (Signature of Notary Public- State of Florida)
ignature of !Votary Public- State of Florida )
Commission No. .�'.. "...,.CUMMWA
M�IFW2
mmission No. lt�ititi
it ' tbmTAm 19, 2072
REVIEWS
FRONT
.....,.
SUPERVISOR
PLANS
VEGETATION
d
Vio" N Li
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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Relocated swi
DINING ROOM
Nvw GFI rocp
3) Now pondant fix
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Existing duple
rocpt
KITCHEN AREA