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HomeMy WebLinkAboutbuilding permit applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEi; Date: 4/12/16 Permit Number: RECEIVE® Building Permit Application Ap®1 g 2016 Planning and Development Services APR Building and Code Regulation DivisionQ�L�� 2300 Virginia Avenue, Fort Pierce FL 34982 (i Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial 0 Residential PERMIT APPLICATION FOR: Electrical PROPOSED IMPROVEMENT LOCATION: Address: 6099 Shinn Road Port St Lucie; FL 34952 Legal Description: 7 36 39 S 112 OF N 1/2 OF SW 114 AND N 112 OF S 112 OF 1/4-LESS E 50 FT AND LESS W 43.5 FT- (77.22AC) (OR 3735-62) Property Tax ID #: 3307-313-0000-000-2 Lot No. Site Plan Name: Block No. Project Name: PUMP HOUSE SERVICE RE -BUILD Setbacks Front Back: Right Side: Left Side: DETAILEDDESCRIPTIONOF WORK: RE -BUILD OLD DAMAGED 100A 3 PHASE -SERVICE ON POLE AT EXISTING PUMP HOUSE. CONSTRUCTION INFORMATION: Additional work to e nertormed under this permit —check all apply: ❑HVAC0 Gas Tank ❑Gas Piping _ Shutters R] Electric ❑ Plumbing []Sprinklers ❑ Generator Total Sq. Ft of Construction: _ Cost of Construction: $ 1300.00 S Ft. of First Floor: Utilities:Sewer ❑Septic ❑ Windows/Doors ❑ Roof Building Height: OWNER/LESSEE: CONTRACTOR: NameRJM DEVELOPMENT, LLC Name: JAYES L REISNER Address:8530 SW JAYME WAY Company: JIM REISNER ELECTRIC, LLC Address. 4886 SW HONEY TERRACE City: PALM CITY State FL Zip Code: 34990 Fax: 772-288-0983 City: PALM CITY State: FL Phone No.772-288-0951 Zip'Code: 34990 Fax: Phone No. 772-260-0732 E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mail: jamesreisner@bellsouth.net from the Owner listed above) State or County License- EC-0002442/ SLC 20125 If value of construction is 52500 or more, a RECORDED Notice of commencement is requires. SUPPLEMENTAL CONSTRUCTIM-LIEN LAW INFORMATION: DESIGNER/ENGINEER: _, Not Applicable Name: _ Address: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: _ Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: 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, accessorystructures, 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 com ci g work or recording our Notice of Commencegj! r `� n r- - S ture of Owner/ Lessee/Agent STATE OF FLORID110. COUNTY OF +'r� W `• The f going instru ent was cknowI dge bef b r z A this day of 2(/0 mO rng !2 g is ae S (Name of person acknowledging) L-23 N (Signature of N t ry Public- State of Flor da ) Personally Known =Feddetification Type of Identification Produ41, Commission No. (Seal) Revised 07/15/2014 of STATE OF FLORI COUNTY OF The f7 oing instrument was acknowledged befo ri this I day of 20 //� b a L s i'n k ( ame of person acknowledging) of NoYaiv Public- State of Personally Known OPro uc d Identific tion Type of Identification Produced Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS