HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` 0/�
Permit Number: I — I
Yam RECEIVED
® MAR 0 6 2018
Building Permit Application Permittingoepertme
Planning a d Development Services St. Lucie Cn11A, `�!`7
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical
BY
Commercial Residential x St. Lucie
PROPOSED IMPROVEMENT LOCATION:
Address: 9103 Champions WAY
Legal Description: LAKES AT PGA VILLAGE
Property Tax ID #: 3334-501-0079-000-7
Site Plan Name:
Project Name: Toohey
Setbacks FrontQ� X Back: 0
43-32) BLK B LOT 1 (OR 3425-2383; 3545-749; 3570-1347)
Right Side: KO Left Side:
Ilift"_1��3iP7�t�[�l�J����ibY�]A_1:����`l'Lc��gt�i�.x�]:Nir1
0HVAC IJ Gas Tank
®r.,,��jj
Electric 0Plumbing
total Sq. Ft of Construction:
Cost of Construction:$ 11000
Lot No.1
Block No. B
Y, .
Derma— cnecKdu Mapply:
Sas Piping _ Shutters Windows/Doors
Sprinklers Generator Roof Roof pitch
5 Ft. of First
jj Floor: _
Utilities: []
Septic
=1Septic
Building Height:
OWNER/LESSEE:` �;:: � `'
CONTRACTOR "
Name James K Toohey JR)
Name: DANIEL YATES
Address:6910 N Wildwood Ave
Company: EFFICIENT HOME SERVICES OF FLORIDA_LLC
City: Chicago State:IL
Zip Code: 60646 Fax: NIA
Phone No.7738055856
Address: 3121 INDIAN RIDGE PL
City: LAKELAND State: FL
Zip Code: 33810 Fax: NIA
Phone No. 727.218.9407
E-Mail: NIA
Fill in fee simple Title Holder on next page (if different
I from the Owner listed above)
i
E-Mail: BAPROJECl'SOLUTIONS@GMAIL.COM
State or County License:
it value of construction is $2500 or more, a RECORDED Notice of Commencement is required. W ` ' —
SUPPLEMENTAL COIUSTEtUCTION LIEN, L.AUV INFQfMATION
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
x Not Applicable
Address:
City:
Zip: Phone
State:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY:
Name:
x Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
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 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.
woq�
Signature Owner/ Les Contractor as Agent for Owner
a of ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF sT LUCIE
COUNTY OF sT LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 1 '4% day of ZYr„n
, 20 19 by
this _ $_ day of 11lGrch . 2019 by
�Lct�a.S
iJ
�iu1�.e\�!CA*es
Name of person making state nt
Name of per n making statement
Personally Known OR Produced Identification x
Personally Known OR Produced Identification x
Type of Identification
Type of Identification
Produced oL
Produced DL
(Signature of Notary Publ c- Stat
of F on a
(Signature of No ary ub c- St to of Florida )
Commission No.
Notary Pub of of Florida
N
Commission No. Notary Pu eal�te of Florida
+�
mothy Cb`If��yyl
My Commission GG 248671
08115120 22
s° Timothy Coffey
y a My Commission 248671
Expires
22
Expires 0811512022
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Rev.8/2/17