HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPT
Date: / 0 - 8- % F t Permit N
D O CT
�8n4 i
12V P'<_z &!'111 t1f t
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® OCT 0 3 2013
Building Permit Applicati %rmitting C epartin
Planning and Development Services ��. LUCi� �� <e �c'C1t
Building and Code Regulation Division .,r c u it tYr FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR:
Generator
E
PRQPOSED f'MPR'OVF,M'ENTt`OCAT
ON
-
Address: Zo 10 J S 1:;1 J � C!_'6r • T'U — P\ev C.e FL- �,4 1
Legal Descrlption: OLMSTEAD PLACE S/D LOT 4 (OR 1884-2557)
L'arrr)Q9
Property Tax ID #:-3412-502-0004-000=3 Log nod w
Site; Plan Name: Block No.
Project Name: STRUVE
Setbacks Front Back: Right Side: Left.Side:
�DETaILEDaD'ESCRIIPTION OF.WORK::
GENERATOR INSTALLATION
„CONSTRU:CTIC+N .I'NFORNhATI;ON
ntiona wor e o e , orme un ler t is permit— check hall apply:
0HVAC 0 Gas Tank ❑Gas Piping Shutters Windows/Doors
ElElectric 0 Plumbing []Sprinklers Generator l Roof Roof pitch
Total Sq. Ft of Construction: - S . Ft. of First Floor:
Cost of Construction: $ 12,850.00 Utilities: 0Septic Building Height:
I
aWNER/LESSEE;
,CONTRACT.OR
Name. f ak t L -1- I—Au-n- la S: �_oa '_
Name: &,�"e vVz
Address: 1, q6 9 S 37n � an 4 —
Company: COMPLETE ELECTRIC INC
City: ✓�"_ 0s e,rre< State:FL
Address: & 31 Se6 IS IV A
Zip Code: 34982 Fax:
City: R e b & t -3' I it eN State: FL
Phone No.772-473-2828
Zip Code: 32958 Fax: 772-388-2411
EMail:treasurecoasttil@bellsouth.net
Phone No. 772-388-0533
Fill in fee simple Title Holder on next page If. different
E-Mail: dregan@completeelectricinc.com
from the Owner listed above)
State or County License: EC0001911
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is.required.
S.U'PPLEM!ENTAL CO'NSTR'UCTI.ON'
LIEN ILAW
IN:�FORMATiO:N.
DESIGNER/ENGINEER:
— Not Applicable
MORTGAGE COMPANY: _ Not Applicable.
Name:
Name:
Address:
Address:
City:
Stater
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ _ . Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
Zip: Phone:
City:
Zip: Phone:
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
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 approvedplans, 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 iyispection. If you intend to obtain financing; consult with lender or an attorney before
commencine work or recording-vour Notice of Commencement.
lgna re ofOwner/Lessee/Cantracton,as-Agent for-Qvi Wr�--::::�i
` Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF I'ar) R ver
STATE OF FLORID .
COUNTY OF /t a-f-. rov-cw'
_JNgd
The forgoinginstrument was acknowledged_before me
this-4day of �i�i III , 204 b
ing instrument was acknowledgedb.efore me
The Ty—dayof
this Q1479 h�,� 20 I by
,
4 vlc_�
r-) e, � niz
—
Name of person making statement
Name of perEaDmaking statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
P duced
Produced
S a4lir cI�jiQMOPUBLIC
(Signature of Notary "Z151 c- State of F o a )
_STAY OF LFLORIDA
VNo.
C mmissi°C FF93309g
Commission No. G6v ?r2apa�p I,
ea COURTNEY E R
tlotary
Commr
s�NCEIa Expires 11/2/2019
¢ Public - Stat
C = ", Commission # GG
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
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5EA T9_R"tTI E�zMANGO-
ndedthrou h a ' nal
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COUNTER,
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
728
2020
y Assn.