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HomeMy WebLinkAboutBuilding Permit (2) ,1 LL APPLICABLE INFO MUST BE COMPLETED FOR APPIJCATION TA BE ACCEPTED Date: Permit Number: 2004.0471 Building Permit Application Planning and Development Services Building,and C,otle Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: Electrical PROPOSEDa,MPRQVEMENT LOCATION _= Address: 15 AZUL Legal Description: EAST 1/2 OF SECTION 1 -TOWNSHIP 34S-RANGE 39E Property Tax ID#: 1301-111-0001-000-5 Lot No. Site Plan Name: COUNTRY CLUB VILLAGE Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION'OFWORK METER MAIN COMBO AT 15 AZUL CONSTRUCTION INFORMAT11- ION Additional work to be nerformed under t ispermit—check all tbat,appy: HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof Total Sq.Ft of Construction: SFt.of First Floor: Cost of Construction:$ 200.00 Utilities:cnSewer 0Septic Building Height: OWN€R/LESSEE CONTRACTOR Name WYNNE BUILDING CORP. Name: ALAN WALTON Address:8000 SOUTH US HWY. 1 -SUITE 402 Company: FLORIDA STATE ELECTRIC City: PORT ST.LUCIE State:FL Address: 751 16TH AVE. Zip Code: 34952 Fax:(772)878-7656 City; VERO BEACH State: FL Phone No.,(772)$7&5513 Zip Code: 34962 Fax: E-Mail: Phone No. (772)539-1574 Fill in fee simple Title Holder on next page(if different E-Mail: floridastateele@gmail:com from the Owner fisted above) State or County License: 27267 N value of construction is$25W or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not nFFfiEaE MORTGAGE COMPANY: _ Not Applicable Name: Zip: _Phone: FEE SIMPLE TITLE HOLDER: __ Not Applicable Name: Zip:_ Phone: BONDING COMPANY: _Not Applicable Name: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permir to do the work and instaliation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Countv makes no representation that is srantins a oermit will authorize the permit holder to build the subiect structurewhich is in conflict with anv a'pplicable Home Owilers Asiociation rules. bvlaws or and covenants that mav restrict or prohibit such structure. Please consult With your Home Owners Association and review'your deed for any restrictions rrrihich may apply. ln consideration of the granting of this requested permit, I do hereby agree that lwill, 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 NOTTCE OF COMI}IENCEMENT MAY T}YICE FOR IMPROYEMENTS TO YOUR PROPERTY" A NOTICE OF COMMENCEMENT RESULT IN YOUR PAYING MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO AtN FINANCING, CONSULT WITH YOUR RECORDING YOUR NOTICEAN Signature of Ownerl 'Contractor as Agent for Owner STATE OF FLORI COUNTY OF The forgoing instrument was acknowledged before me this _ day of Personally Known v/ OR Produced ldentification Type of ldentification Produced person making statement. Public- State of Florida ) STATE OF FLORIDAO /] , . COUNTY OF Nza-) 2L L"r c, 'f The forgoing instru acknowledged before me this ZZudaV of Name of person making statement. Personally Known t OR Produced ldentification Type of ldentification ry Public- State of Florida ) p0RoTHY 48UA,}SKIN REVIEW REVIEWS REVIEW DATE RECEIVED SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:a Name: Address: City: Address: City: Add ress: Citv; Zip: _