HomeMy WebLinkAboutPermit App Signed ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 YES
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 8412 MUIRFIELD WAY PORT ST LUCIE, FL 34986
Legal Description: POD 27 AT THE RESERVE MUIRFIELD REPLAT LOT 32
P ro pe rty Ta x I D#: 3328-802-0035-000-2 Lot No.32
Site Plan Name: Block No.
Project Name: 8412 MUIRFIELD WAY
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORD:
INSTALL NEW 15AMP DEDICATED CIRCUIT AND CIRCUIT EXTENSTIONS FOR 4 NEW GFCI
TO EXTEND POWER FOR NEW SHUTTERS
CONSTRUCTION INFORMATION:
itiona wor to a er orme un er t js permit—c ec a app y:
�HVAC F Gas Tank Gas Piping Shutters Q Windows/Doors
✓Z Electric ❑ Plumbing Sprinklers 11 Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 1,149.71 Utilities:Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name RICHARD WRIGHT Name: GEORGE G SANCHEZ JR
Address:8412 MUIRFIELD WAY Company: EXCEL ELECTRIC LLC
Cit PORT ST LUCIE State: Address: 1391 SW BELLEVUE AVE
y'—
City: PORT ST LUCIE State:FL
ZipCode: 34986 Fax:
Phone No.518-209-2992 Zip Code: 34953 Fax:
E-Mail:RWWPGA@AOL.COM Phone No. 561 408-0722 772-529-1091
Fill in fee simple Title Holder on next page(if different E-Mail: EXCELOFFICE77@GMAIL.COM
from the Owner listed above) State or County License: EC-13006483
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing wiDir -orTeporcling your Notice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST wCiE COUNTY OF STL-IE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1ST day of OCTOBER 20 20 by this 1ST day of OCTOBER 20 zo by
GEORGE G SAN6HEZ JR GEORGE G SANCHEZ JR
(Name of person acknowledging) (Name of p son acknowledging}
lgnature of of ry Public-State of Florida) (Signature of Not Public-State of Florida)
Personally Known x OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. GG 943316 Y t*�ublic State of Florida on mission No. GG 946316 �ublic State of Florida
Ashley Simiamany Ashley Simiarnany
g My Commission GG W316 My Commission GG W316
a a xprres a a
Revised 0711 5/2014
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