HomeMy WebLinkAboutBuilding Permit Application 11/06/2019 9:31 AM FAX 7724663765 APPLEBEE ELECTRIC 0001/0004
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/05/2019 Permit Number:
- ;--A RECEIVED
i
- - --- - Building Permit Application NOV 0 6 2019
Planning and Development Services ST, Lucie County, Permittin
Building and Code Regulation Division
2.300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE: ELECTRICAL
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Address: 2501 N OCEAN DR
Property Tax ID#: 1425-603-0007-000-8 Lot No.
Site Plan Name: Block No_
Project Name,
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REPLACE BROKEN WEATHER HEAD
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Additional work to be performed under this permit–check all 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:$ 250.00 Utilities: _Sewer _Septic Building Height:
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Name HRISOULA PLANKER Name: JOHN M.APPLEBEE
Address: 2501 N OCEAN DR Company:JAK, INC dba APPLEBEE ELECTRIC
City: FT,PIERCE, FL State:_ Address: P,O.BOX 15
Zip Code: 34949 Fax: City: FORT PIERCE, State: FL
Phone No.(772)201-6448 Zip Code: 34954-0015 Fax: (772)466-3765
E-Mail: Phone No(772)466-7930
Fill in fee simple Title Holder on next page(if different E-Mail APPLEBEEELECTRIC@BELLSOUTH.NET
from the Owner listed above) State or County License EC 0002956
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.
11/06/2019 9:31 AM FAX 7724663765 APPLEBEE ELECTRIC 0002/0004
SUPPIEM;ENTAI;hC4N�STR`t•1CTI0'NI�LI:EN'•••: �: `'•�`° ='•
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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 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 RECORDING YOUR NOTICE OF COMMENCEMENT."
Si nature f Owner/Lessee/C n ctor as Agent for Owner 51 nature of ontractor/Licens H der
ST OF FLORIDA ST F FLORIDA
COUNTY OF- MUCIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this oaTH day of NOVEMBER 2019 by this asTH day of NovEMaER 2019 by
Name of person making statement. Name of person making statement.
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signe of Notary Publ (Slgnaiure of Notary Public-S
,; •� 4 MEU55APARRAMORE 0��kp MELIS5APARRAwtOAE
Commission No.GG 1269 ,� a: Notarypuhltc-Stateafflwtda Commission No.GG 126946
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mssion i GG 126946
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
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COMPLETED
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