HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a Permit Number: \130�
RECEIVE®
Building Permit Applicat on SEP 2 4 2019
Planning and Development Services ST. Lucie County,
Building and Code Regulation Division ty, Permitting
2300 Virginia Avenue,Fort Pierce FL 34952
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Farm Residential
PERMITTYPE:
VA
PRO_ROSE®FI_MPROVEIVI_NT LL_dCA`T10_N
Address: - - - -
PropertyTax ID#: 4228-311-0001-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
®ETAILED,DESCRIP%TIO,N`OF W®RK: -'- �-
_Install 60amp pump service
CO:NSTR+UCTION I:NF 'IVIATIQN.
Additional work to be performed under this permit-check ail 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:$ 1.500 Utilities: _Sewer —Septic Building Height:
`CONTRACfO'�R,µ
Name-Joel W. Bass Name: Joel W. Bass
Address: 8661 Center Street E Company: Bass Electric of Florida. Inc.
city: Okeechobee State:FL Address: 2801 SW 3rd Terr
Zip Code: 34974 Fax: city: Okeechobee State: FL
Phone No. 863-467-8705 Zip Code: . 34974 Fax: 863-467- 752
E-Mail: jbass39 hotmail.com Phone No 863-467-8705
Fill in fee simple Title Holder on next page(if different E-Mail Bass2801(W-hotmail.com
from the Owner listed above) State or County License FC13001339
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.
SUP;I? EM'E�ITAL C�O_NTRAU" IONr`LIEN LA.W
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 Now"IF COMMENCEMENT MUST BE RECORDED AND
�O TED ON THE JOB SITE BEFORE THE FIRST INSPEC . IF NOU INTEND TO OBTAIN FINANCING, CONSULT
WrFH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOOR NOTICE OF COMMENCEMENT."
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ature of Owner/ essee/Contract&-as-Agent forOwner Si a Ye of Contractor/ 'cense HolderATE OF FLORIDA ST E OF FLORIDA
COUNTY OF 5�- �-uc�@ C LINTY OF Okeechobee
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�dayof� }- 20a by this-2D September-_,20�by
-5G%\ �A 3 S Inpl W Racc
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known XX OR Produced Identification
Type of Identification Type of Identification
Produced L �Q t- Produced
(Signature'of Notary PubW--State of Florida) (Sig
Notary Public State of Fl/orriids
Commission No, �aaa-� (Seal) Commissio I;i� i Mandy E Stator 358xroal�
jaF Expires 0712412023
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