HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: 2/5/2015 Permit Number: )i soz"— QO I
__— - --" SCANNED
Building Permit Application By
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Electrical 1171 1
Address: 9765 RANGE LINE ROAD
Legal Description: 01 37 38 THAT PART OF SEC LYG SELY OF AND CONTIG TO FEC RR MPDAF: BEG NE COR SEC, TH S 00 DEGOO MIN
54 SEC W ALG E SEC LI 1907.98 FT TO POE, TH CONT S 00 DEG 00 MIN 54 SEC W 300FT, TH N 89 DEG 59 MIN 06 SEC W 1170 FT
Property Tax ID #: 4201-113-0001-010-6
Site Plan Name: LIBERTY TIRE RECYCLING, INC.
Project Name: LIBERTY TIRE
Setbacks Front Back: Right Side:
Left Side:
Lot No.
Block No.
DETAILEDfDESCRIPTIOIV OF WORK y`�` .. +� R.��_ ram` a,:•
REPLACE CT METER CAN WITH FPL AT BUILDING #1
CONSTRUCTION INFORMATION;
L_IHVAC L_J Gas Tank
RiElectric Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 500.00
Piping LJShutters
ars L.1 Generator
S Ft. of First Floor:
Utilities:"n Sewer O Septic
Windows/Doors
13 Roof
Building Height:
OWNER/LESSEE:'
CONTRACTOR
Name
Name: Garett Guidroz
Address: o;l
Company: Complete Electric, Inc.
City: yP'9i�t �✓ L
Zip Code�Sa.7 2g Fax:
Phone No.
State��
Address: 637 Sebastian Blvd.
City: Sebastian State: FL
Zip Cade: 32958 Fax: 772-388-2411
Phone No. 772-388-0533
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: mmacleary@completeelectricinc.com
State or County License: EC0001911
If value of construction is $2500 or more, a RECORDED Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION_tLIEN�IANINFORMATICli1ION
DESIGNER/ENGINEER:
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 con list 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.
'fh 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
Eommencine work or recordine vour Notice of Commencement.
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTYOF Irrit_i.A 131,494'2
The forgoing instrument was acknowledged before me
this day of Pj'z1orLA20 I_zrby
(Signature of Not u ic- State of Florida )
Personally Kno OR Produced Identification _
Type of Identification Produced
Commission No. El: lo�F
M�ypve_ Notary Public State
MY Commission EE104878
Revised07/15/2014 110,ro°P EXOGS0snar2015
s
Signature of Contractor/License der
STATE OF FLORIDA
COUNTY OF iadian R.r
The forgoing instrument was acknowledged before me
this 5" day of Fab"ary 20 _ by
Garen Guid.
(Name of person acknowledging )
(Signature of t)Yota7y Public -State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
No. EE166918
? AA : Maddoll Hatfield
•9 My Commissbn EE104878
Expires 09119/2015
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