HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,-
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�
Date: 4/3/2018 Permit Number: ' 90-4— 011 3
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Building Permit Application �4 ?018
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Planning and Development Services
Building and ode Regulation Division 't' Laels county
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: ElectlricalEl
PROPOSED IMPROVEMENT LOCATION:
Address: 170 Eaton dr, Port Saint Lucie, FI, 34983
Legal D n: installation of a dryer, whater heater, and range plug. q g +7-,
Property Tax ID #: ?J`t l % ` �� 5 • ��� ' �� ' Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
19_'11 �' r1t)
CONSTRUCTION INFORMATION:,
Additional work to e e orme under tislpermit—checka apply:
OHVAC E] Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
RiElectric 0 Plumbing Sprinklers � Generator E]Roof Roof pitch
Total Sq. Ft of Construction: I S . Ft. of First Floor:
Cost of Construction: $ 700 I Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name_ L
Name: George Ruiz Ortiz 1
Address:170 Eaton Dr
Company: Imperium Electric LLC
City: Port Saint Lucie State:FL
Address: 265 se verada ave
Zip Code: 34952 Fax:
City: Port Saint Lucie State: FL
Phone No.
Zip Code: 34983 Fax: 772 237 0318
E-Mail:
Phone No. 772 444 7040
Fill in fee simple Title Holder on next page ( if different
E-Mail: imperiumelectricllc@gmail.com
from the Owner listed above)
State or County License: ES 12001619
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
N a m e: Chaz Munn
N a m e: George Ruiz Ortiz
Address:170 Eaton dr, Port Saint Lucie, FI, 34983
Address: 17o Eaton Dr
City: PortsaintLucle State:
City: PortSalnlLucle State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name: I
Name:
Ad d ress: 265 se verada ave I
Address:
City:
City: I
Zip: Phone: I
Zip: Phone:
DWNER/ 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 applicationls 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 failu�e to Record a Notice of Commencement may result in your paying twice for
improvements to your property. � Notice of Commencement must be recorded and posted on the jobsite
before the first inspection you intend to obtain financing, consult with lender or an attorney
commencing work or rec rd ,ng your Notice of Commencement. p V"V
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Signature of Owner/ Les e t a
for as gent
Signature of Contract r/Li se H eSTATE
OF FLORID
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STATE OF FLORICOUNTY
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mCOUNTY
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forgoing instrument w s ackno
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The fgr�oing instru ent asac owledge
this7i day of API
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this day o 20%
Name o rson making statement:
-
Name o son making statement
Personally Known OR Produced Identifi
Personally Known OR Produced Identification
Type of Identi tin
Type of Ident 'ca
Produced
Produced
(Signature of Notary lic- State of Florida )
(Signature of Notary blic-State of Florida)
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17