HomeMy WebLinkAboutApp E - 5375 Oakland Lake Cir #CATV ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Wl5/2020 Peonrc Number.
Building Permit Application
Planning and Development Serylres
Buildi
and Code
Pie
Phone: Part(]]2) 46 Regulationasua Awn 53 Fax�(]]2) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Addryw 5375 Oakland Lake Or #CAN
Legal oascnpsion: Oakland Lake Estates (FOR W-141 TRACT A (as per plat dedication dated Imam)
Property TaxlD #: 1311-a00-0003-000-5 Int No.
Site Plan Name: SP - Oakland Lake Estates - 5375 Oakand Lake Cir#CAN Block No.
Projecttheme: rarnwhon PnwAepply Cimmet - Oakland Lake Estates
Setbacks From_ Back: Righ[ Side: Left Side: _
DETAILED DESCRIPTION OF WORK:
Install Co rdi sl power supply cabinet/service feeder approximately at FPL hand hole South of 5373
Oakland Lake Cir driveway - 14 R east of Oakland Lake Cir, 40 it north of Lakeview Ur
CONSTRUCTION INFORMATION:
InIp�erms — ec app
11❑�IHVAC o o Gas Tank un er []Gas Piping 11��_11 Shutters ❑Windows/Doors
ZElectric El Plumbing ❑Sprinklers LJGenerator ❑ Roof O Roof Pitch
Tonal Sp. If of Construction: a.25 S k. of Hid Floor:
cost of Construction: $ 616.00 Dt, ties .ewer ❑septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Camelot - Jared Pope Name: G J Gifted
Address: 3960 RCA Blvd, Ste 6002Company: Gary J GiRdo. Inc.
CIry: Palm Beach Gardens State: FL Addre«r 350 SW Leaden St
Zip Code: 33410 F ax City: Stuart to FL
Phone No. 561-804-0957 Zip Code: 34997 Fax T/2-219-0146
Mail:lared.poPe($comcastnm Phone No. T/2-286-0954
Fill in fee simple Me Holler an next lisle l IF different E-Mail: 9HfelecMcomratnet
from the Owner listed above) tear County License: EC13MIS74
if value of connructim 6Used or more,a RECORDED Notice cecam romement is reRuined.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEEIR Not Applicable MORTGAGECOMPANY: = Not Applicable
Name: Name:
Address: Address:
City: State: _ City: State: _
Zip: Phone Zip: Phone:
FEE SIMPLETITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: all
Address: Address:
CITY: Cli
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made ro obtain a permit to do the work and msullation as Indicated
certify that no work or installation has commenced prior to the Issuance of a pemif.
makes no representation the is granting a permit will authorize the it holds to build the subject structure
w�uRu�si Pl n its
onin any Ie Home Owners Aswnatlon rules, bylawz Or an]] hat may restrlR or prohibit such
It wit tiPyour Home Owners Assoclatlon and reWew your tleetl /orr ayny resstrictions which may apply,
In consideration of the granting of this requested in once eFloridaBuill Coco sane St Wel.`cwill,vnmendmee`nntt4pedp,m the work
The toll wine bunging permit applications arc exempt from Federal full concorrency review: room addltbns
swimming Pools fences, walls, drunk, screen rooms and accessorry, useseanother non-residentia use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result In your paying twice for
Improverments
inspection.ropertou nNendtof obtain CommencementRa must be recorded and posted on the jobsite
beforcommencingswork or recording your Notice of Comme cemnd Fill coes�lt with lender oranattorney be ore
et
serum reof OwnerL nmttoras Agem for Owner Slgna lire of Cantakelmenticense Holder
STATE OF FIURIDA STATE OF FLORIDA
COUNTY OF Nzmn COUNTY OF Martin
The foiling marument was acknwledged before me The foraolneinstrument was acknowledged before me
6isl8th day of 20_ by thislgtbdayof All 20M by
surgical ,arviGmord
marine me of person making
TyponalroNownpenyon OR Produced! mentifcatlon_ Personally Known X OR produced Identification
e of Identification Type of Identification
Produced ProduandE_
lsgature of Nat m ; n, iPi.wm'> 'iho
Isidnatiane o arulesm
mm s �f �v p
REVIEWS FROM ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW RENEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. Ill