HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO CM/UST BE COMPLETED FOR
Date:
TO BE ACCEPTED
Permit Number:
Building Permit Application RFcEn,F®
Planning and Development Services
Building and Code Regulation Division APR 1 ?018
2300 Virginia Avenue, Fort Pierce FL 34982 P@rmItting 0®
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Retld�vrt;�
PERMIT APPLICATION FOR: Generator I
PROPOSED :I M PROVEM ENT LOCATION
Address: 7802 HIBISCUS RD. FORT PIERCE, FL 34951 I
Legal Description: LAKEWOOD PARK UNIT 5 BLK 48 LO� 12 (MAP 13/11 N) (OR 379-1615)
Property Tax ID #: 1301-605-0212-000-3
Site Plan Name:
Project Name: GILL
Setbacks Front Back:
GENERATOR INSTALLATION
Right Side
Left Side:
Lot No. 12
Block No. 48
01NNER/LESSEE
CONTRACTOR.:
.,
Name BOBBY J. & JUDITH A. GILL
Name: GARETT GUIDROZ
Address: 7802 HIBISCUS RD
Company: COMPLETE ELECTRIC INC
Address: 637 SEBASTIAN BLVD
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 772-521-8551 :1 -17 _ H oLr7
City: SEBASTIAN State: FL
Zip Code: 32958 Fax: 772-388-2411
Phone No. 772-388-0533
E- Mail .l cregan@completeelectricinc.com
E-Ma i l :
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State o i Cou my License: EC0001911
it value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRUCTION LIE LAIN INFORMATION:
,.
DESIGNER/ENGINEER: _ Not Appl'pcable
MORTGAGE COMPANY: _ Not Applicable
Name: I
Name:
Address:
Address: I
City: Sta e:
City: State:
Zip: Phone: I I
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address: I
City: I
City:
Zip: Phone: I
I
Zip: Phone:
I certify that no work or installation has commenced p 'IIIior 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 As99sociation rules, bylaws or and covenants that may restrict or such
prohibit
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 permiU I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Build �ng Codes and St. Lucie County Amendments.
The following building permit applications are exempt frgm undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, sign§, 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 work or recordingyour Notice of Commencement.
I
s
r Signature-of-Owner/-Lessee/Agent -
Signature of Contractor/License Holder
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF I,r OL, �'ylo,-
h
COUNTY OF n 0 1 0�/� �/ �✓
The forfoin instrum nt was acknowled a afore me
this �—day of ��i \ 20 1 aby
The for oing instrument was acknowledged efore me
this_ �ay of Apvi 20 L by
(Name of person acknowle g)
(Name of person acknowledging)
(�
(Signature of Nota Public- Statelff Florida)
(Signature dflTotary Public- State of Florida )
PersonallyKnown OR Produced Identification 1/I
Personally Known �R Produced Identification
Type of Identification Produced %c- I
Type of Identification Produced
Commission No. (Seal) I
I
(�
Commission NoGG 6 .31-7Zd (Seal)
Revised 07/15/2014
\I III \\• aV P •/
• SP �� COURTNEY E REGAN
=2°• b °: Notary Public State of Florida ;'?°,�; Notary p
Y ublic
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9. p • Commiss.an # GG 031728 _. p ._ - State of Florida
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