HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL 'PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dat t $�a31 �q Permit Number:
CANNED
BY
t. Lude G®i�nty RECEIVE®
' Building Permit Application AUG 2 2018
Pla �ing and Development Services
Bull ing and Code Regulation Division ST. Lucie County, Permitting
2301 Virginia Avenue, Fort Pierce FL 34982
Ph �e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
�t
eu'e l_
Addr Iss: 9037 Champions Way Port St Lucie, FL 34986
Legal (Description: LAKES AT PGA VILLAGE (PB 43-32) BLK A LOT 26 (OR 3244-138
Site
Proj
Set
y Tax ID #: 3334-501-0040-000-5
i Name:
Name: Grayson
cs Front Back:
Right Side: Left Side:
Lot No.
Block No.
Wire electric for 200A Automatic transfer switch to generator (generator permit by others)
Aaal ,ional worK to oe errormea
HVAC Gas Tank
Lr ll Electric ❑ Plumbing
Total I q. Ft of Construction: 3256
Cost ,If Construction: $ 3600.00
unaer tnis permit - cnecK an apply:
[]Gas Piping _ Shytters a Windows/Doors
Sprinklers — generator Roof Roof pitch
S Ft. of First Floor: _
Utilities:In Sewer E]Septic
Building Height:
z
X
4&
Nam
Robert Grayson Rita Turner
Name: Sam Crane
Address:
Company: Sam Crane Electrical LLC
9037 Champions Way
City:
�Port St Lucie State: FL
Address: 3324 SE Gran Park Way
Zip
ode: 34986 Fax:
City: Stuart State: FL
Phone
No. ���- `\y\ - -sr. SI1
Zip Code: 34997 Fax:
'il:
E-M
Phone No. 772-223-8865
Fill i
' fee simple Title Holder on next page ( if different
E-Mail: samcraneelectric@yahoo.com
from
the Owner listed above)
State or County License: EC0001986
If valee of construction is $2500 or more, a RECORDED Notice of Commencement is required.
WDESIN
��'.��!'.�26 .'+` iir fffik g fi y.w.N x,v�e
MORTGAGE COMPANY: _ Not Applicable
Name:
Nam��ll
NGINEER: Not Applicable
State:
Address:
City:
Address:
City: State:
Zip:
Phone:
.I
Zip: Phone:
FEE
Nam
IMPLE TITLE HOLDER: _ Not Applicable
LI
BONDING COMPANY: _Not Applicable
Name:
Addr�ss:
Address:
d
City:
City:
,I Phone:
it
Zip: Phone:
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lu ie 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
struct re. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In con ideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acc °rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
i
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accesiory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impr wements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befo l��e�' the first inspection. If you intend to obtain financing, consult with lender or an attorney before
corn encine work or recording vour Notice of Commencement.
s
as Agent for Owner Signature of Cont acto ode
STATE OF FLORIDA-M L STATE OF FLORIDA /
COUNTY OF / �Ccl�'L 1 COUNTY OF.�G�v�?/�
The f "Irgoing instru nt was-knowled ed before me
this day of U 20 l(Lby
of person acknowledging)
(Signature of Notary Public- State of
The forgoing instru ent was acknowledged efore me
this V day of 20 by
I,eo bee � C �
(Name of person acknowledging)
(Signature of Notary Public- State off lorida )
Persor��ally Known OR Produced Ideptification v I Personally Known OR Produced Identification
Type of Identification Produced �L D� Type of Identification Produced
'I 1�5o?OJ �/0 (Seal)
Com ission No. qD M�fJ$WJmand9Z Commission No.
,�,°� NO"Public MiroslavaHemand
Revised 07/15/20 �o< Stateo ores gala 19
Rev°4� MateofFlorida
I Commission Exp'�F 920540 ` �� Commission Expires 9(
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or
Conuriiss►on
REVI
EWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
I
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
'l
COMPLETE
INITIALS
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