HomeMy WebLinkAboutBUILDING PERMIT APPLICATION0
ALL APPLICABLE INFO MUST BE COMPLETED -FUR APPLICATION TO BE ACCEPTED 1 �\ z
Date: SCANNED Permit Number: S 1�o —
BY
___.ti_-
St. Lucie County
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: Generator
Address: 9403 MEADOWOOD DRIVE FORT PIERCE, FL 34951
Legal Description: MONTE CARLO COUNTRY CLUB -UNIT ONE -LOT 181 (OR-3930-403)
Property Tax ID #: 1327-801-0070-000-7
Site Plan Name: WELCH
Project Name: WELCH
Setbacks Front Back:_
GENERATOR INSTALLATION
11HVAC
11 Electric
Lot No.181
Block No.
Right Side: Left Side:
"Shutters
0 Plumbing Sprinklers Generator Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ q,UQ"od Utilities:liSewerElSeptic
Name DEBORAH A WELCH (TR)
Address:9403 MEADOWOOD DRIVE
City: FORT PIERCE State:FL
Zip Code: 34951 Fax:
Phone No.678-591-4922
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
❑ Windows/Doors
Roof
Building Height:
Name: GARETT GUIDROZ
Company: COMPLETE ELECTRIC INC
Address: 637 SEBASTIAN BLVD
City: SEBASTIAN State: FL
Zip Code: 32958 Fax: 772-388-2411
Phone No. 772-388-0533
E-Mail: cregan@completeelectricinc.com
State or County License: EC0001911
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SFFLEt[INT""'L QfiSTRUCTfQILIEN{1tl1NEMATt35^
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DESIGNER/ENGIN R: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:DEBORAHAWELCH
Name: GARETTGUID z
Address: 9403 MEAD OD DRIVE
Address: 9403 MEADOWOOD DR FORT PIERCE, FL 34951
City. FORT PIERCE State:
City: SEBASTIAN State:
Zip: Phone
Zip: Ph ne:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name: I
Name:
Address:
Address:637SEBASTI NBLVD
City:
City:
Zip: Phone:
Zip: Ph one:
OWNER/ 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
Home Owners Association bylaws covenants that may restrict or such
which is in conflict with any applicable rules, or and 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 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 work or recording our Notice of Commencement.
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF T� Of I a-►') tzt V—C V-
STATE OF FLORIDA
COUNTY OF
The fo Ing instrument was acknowledged before me
The fo Wing instrument was acknowledged before me
this day of T2.Q , 20 by
this day of �4r1 e 20JJ by
to ` l C) --
G C u--r '�wZZ
Name of person making statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced 5L
Produced
C P2�'
CQ1 LW/L\
Ignature c otary Public- State o Florida)
(Signature of Notafy Public- State'off Florida )
Commission N G Cj
Commission No. ,0 ) J2_ (Seal)
,,, COURTNEY E REGAN
`iPf1Y PV�,��
Notary Public State of Florida
; O1PRy�'LB,�� COURTNEY E REGAN
r ,,c,: Notary Public -
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DATE
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DATE
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Rev. 8/2/17