HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
ob
RECEIVeb
Building Permit Application NOv 0 8 2019
Planning and Development Services
SuIlding and Code Regulation Division ST- lude County, 'rmitting
23017 Vire Avenue,Fort Pierce Ft 34982 Residential PL
Phone:(772)462-ISS3 Fax:(772)462-1578 Commercial
If PERMIT APPLICATION FOR: To Select from dropbox, ♦click arrow at the end of lineEAe�J(jCAL
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Address: 12372 HARBOUR RIDGE BLVD 4-4
Legal Description. SOUTH SHORE VILLAGE UNIT 4-4 ( OR 4096-702)
PropertyTax1D#:_ 4426-807-0028-000-9 Lot No,
Site Plan Name; Block No.
Project Name, 5PgXre_
Setbacks Front Back: Right Side: Left side:
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RELOCATE PANEL 3' FROM THE RIGHT OF CURRFNT LOCATION
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F1HVAC Gas []Gas Piping QS'hit'ters Windows/Doors
Electric ■ Plumbing "[]Sprinklen ■ Generator ■ Roof
Total Sq.Ft of Construction: SQ,Ft.of First Floor:
Cost of Constrmction:$ UtIlltles: Sewer 0 Septic Building Height:
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Name: JAMES K WILLIAMS
g 1 Z4 gm 9 ' Company.- IN`qT0N ELECTRIC
Address, 3251 SE DIXIE HWY
City; STUART - -$tate._LL
Zip Code, 34997 Fax: 772--287-2380
Phone No. 87-1353
n"n Film. . r E-mail:gregg@arlingtonelectricinc.com
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11/07/2019 18:03 17722872380 ARLINGTON SERVICE PAGE 62/66
DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: __Not Applicable
Name: Name;
Address: Address:
City: - State: City: State:
Zip: _Phone:- _ _-- Zip: Phone:_
FEE SIMPLE TITLEHOLDER: _Not Appilcable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone;
I certify that no work or Installattott has commenced prior to the Issuance of a permit,
St Luc a CountyY makes no represenntation that Is granting a permit 1111 authorize the permit holder to build the subject sCI cture
w�ilch�s in conflict with anyappllcable Nome 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 f 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 yourpproperty.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection, If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement. t
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_SI slur Dwner(LesseelABent Si ure o ntractor ce a Holder
$TA E OF FLORIDA S TE OF FLORIDA
COUNTY OF MARTIN COUNTY OF MARTIN
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_day of , za by this_day of-__-- 20 _by
JAMES -K WILLIAMS JAMES K WILLIAMS
(Name of person acknowled ung) (Name of person acknowledging)
ill
(Signet otary public-State of Florida) (Signature of No ry Public-state of Florida)
Personally Known X oR produced identification -.____ personally Known X OR Produced Identificatlon
Type of Identification Produced Type of identification Produced
Commission No. (seal) Commission No. (Seal)
6Rtef3G N ROBINSON ;•, YP �; Notary Pubtic.VStatg of FIorlda
Revised 07/15/ =, Notaryfublit'-State of Florida =, ;.= Cammisaldri,tk GG•033149
• GoMfi"6tom#GG 033149202
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X ° My Comm. pies Sep 25',2020 .F;u,�,;.� 0 edihf it kponal Notary Ass f
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