HomeMy WebLinkAboutKHOURIE PERMIT APPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/17120 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 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 8032 KIAWAH TRACE, PORT ST LUCIE, FL 34986
Property Tax ID #: 3327-705-0019-000-3 Lot No.
Site Plan Name: Block No.
Proiect Name: GERARD KHOURIE - 30AMP & 50AMP PORTABLE GENERATOR CONNECTIONS
Setbacks Front Back: Right Side: Left Side:
30AMP & 50AMP PORTABLE GENERATOR CONNECTIONS W/INTERLOCK KIT
raaioonai worrc io oe errorrnee uneer mis permit— cnecrc an apply:
�HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof= Roof pitch
Total Sq. Ft of Construction: SqI -F-t.� of First Floor:
Cost of Construction: $ 2400.00 Utilities:CnSewer ESeptic Building Height:
OWNER/LESSEE;.
CONTRACTOR:
Name GERARD KHOURIE
Name: GARETT GUIDROZ
Address: 8032 KIAWAH TRACE
Company: COMPLETE ELECTRIC,
INC.
City: PORT SAINT LUCIE State: FL
Zip Code: 34986 Fax:
Phone No. 772-979-4145
Address:
i�a J�i00.Sat
�1
�0.t1 Ui�1 G�
City: SEBASTIAN
Zip Code: 32958 Fax:
Phone No. 772-388-0533
State: FL
772-388-2411
E-Mail: PGK7878@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: mcook@completeelectricinc.com
State or County License: EC0001911
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION
LIEN LAW
INFORMATION:
DESIGNER/ENGINEER: Not
Name:
Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not
Name:
Applicable
BONDING COMPANY:
Name:
_Not Applicable
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
mprovements to your property. 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
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY QF INDIAN RNER
GARETT GUIDROZ
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
(Signature of Notary Public- State of Florida
STATE OF FLORIDA
The
forgoing instrument was
acknowledged
before me
this
inN day of auir
20_
by
GARETT GUIDROZ
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signature of Notary Puhlic-State of Florida )
GG 928998 Mri�,-; Seal MACI COOK Co mI8810n No. GG 928e9e �+o•.�•-:r,{ Seal)
MACI COOK
Commission Na. ( ) ;�;}.••
MY COMMISSION#GG9268 8 MYCOMMISSION#GG
EXPIRES:October28,202,;a= EXPIRES: October28,
%,: F'..
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
� COMPLETED
Rev.8/2/17