HomeMy WebLinkAboutPermit AppALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: lQ " 1 " r? ( 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: 5004 ABACA DR
Legal Description: LAKEWOOD PARK -UNIT 12-A- BLK 177 LOT 1
Property Tax ID #: 1301-615-0187-000-9 Lot No. 1
Site Plan Name: Block No. 177
Project Name: FORREST LINK
Setbacks Front Back: Right Side: Left Side:
DETAILED�DESCRIPT�10NFWORK:
REPLACE EXISTING 100 AMP MAIN BREAKER PANEL WITH NEW 100AMP MAIN BREAKER
PANEL
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit — c ec a
❑HVAC Gas Tank Gas Piping ffapply:
Shutters Windows/Doors
1zElectric ❑ Plumbing Sprinklers Generator El Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 2216.05 Utilities: Sewer ESeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name FORREST LINK
Name: GEORGE G SANCHEZ JR
Address; 5004 ABACA DRIVE
Company: EXCEL ELECTRIC LLC
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 772-216-2359
Address: 1391 SW BELLEVUE AVE
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax:
Phone No. 772-529-1091 Qualifier 561-513-1477
E-Mail: FORRESTLINK@ICLOUD.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above]
E-Mail. EXCELOFFICE77@GMAIL.COM
State or County License: EC-13006483
if value of construction is $2500 or more, a RECORDED Notice of c:ommencemeni is requireu.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGI
Name:
Addre!
City: _
Zip:�
ENGINEER: Not Applicable
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
city:
Zip: Phone:
State:
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Citv:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not Applicable
State:
Not Applicable
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 pro erty. A Notice of Commencement must be record steel on the jobsite
before the firstjnspe��ion. I ou int ain financing, consult wit nder or a ttorney b
commencing work or recordin g-your Noticepf Commencement.
_ Signature of Owner/ Lessee/Agent
f L s
Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF lit COUNTY OF�A I A 1 Li .0
The forgoing instrument was acknowledged before me
this :1!4?day of Ja OZ 20 2�by
GEORGE G SAN6HEZ
(Name of person acknowledging )
(Signature �fflotary Pu`f3Hc-State of
Personally Known x OR Produced Identification
Type of identification Produced
The forgoing instrument was acknowledged before me
this _F> day of 20 mil_,__- by
GEORGE G SANCHEZ
(Name f person acknowledging )
(Signature of I�1_otary Public- State of Florida )
Personally Known X OR Produced Identification
Type of Identification Produced
r Nqtq is State of Florida
Commission No. GG946316 t Nota �qq c5lateof lnnda cornmissinn No. GG94fi3t6 .' As}7seyClamany
Ashl y i lamany y i My Commission GG 946316
ffi _C My Commission GG W316 �ij Expires 02/16/2024
Revised 07/ 1512014
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DATE
COMPLETE
INITIALS