HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONIr
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: SGHNNED Permit Number: —al-- J 2 q
BY
St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division ST. L
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTVPE:GENERATOR INSTALLATION
FiROPOSED IIVIRROVEMENTFLOCAlI;ON:: «• "' ; s ` , T � , -, ; # ?t C
Address: 8005 SANTANA AVE FORT PIERC
Property Tax ID #:1301-604-0096-000-0
Site Plan Name: -
Project Name: RUSHEL & BARBARA SMITH
GENERATOR INSTALLATION
FL 34951
Additional work to be performed under this permit— check all that apply:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 10,000.00
_ Gas Piping
_ Sprinklers
_ Shutters
Generator
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
Lot No.30
Block No. 30
—Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR: ,
Name RUSHEL L & BARBARA SMITH
Name: GARETT GUIDROZ
Address-8005 SANTANA AVE
Company: COMPLETE ELECTRIC INC
City: FORT PIERCE State: L
Zip Code: 34951 Fax:
Phone No.772-971-5148
Address:637 SEBASTIAN BLVD
City: SEBASTIAN State: FL
Zip Code: 32958 Fax: 772-388-2411
Phone N0772-388-0533
E-Mail:rismitty49@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail cregan@completeelect(cinc.com
State or County License EC0001911
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
if value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
ii
SUPPLEMENTAL CONSTRUCTIONLIEN LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
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.
Inconsideration of the granting of this requested permit, I do hereby agree that 1 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signatu_re7dfOwner/-Lessee/Contractorva�gent-.for_Owner
.,Signature of Contractor/License Holder
STATE OF
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COUNTY OFORI�FLORIDA
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COUNTY OF
The forgoing instrum. eft was acknowledged before me
The forgoing instrum was acknowledged before me
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this ��of cI U V I 20� by
this �-�day of 20� by
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Name of person making statement.
Name of person making statement.
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Produced Identifi
Personally Known OR Produced IdentificatioF/
Personally Known
Type of Identifuya)ion
Type of Identification _o
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Produced
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(Signature of N tary Public- St a of Florida)
(Signature of Notary PuState ofFlo da
Commission No.67O
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Rev. 21 // 1N