HomeMy WebLinkAboutBUILDING PERMIT APPLICATION02726/2015 9:29 AM FAX 7724663765
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APPLEBEE ELECTRIC 0002/0004
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DatgiL 015 Permit Number:
` SCANNED
Building Permit Application St. Luce County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462.1578 Commercial _� Residential
PERMIT APPLICATION FOR: Electrical
Address: 5250 S. US HWY 1, FT. PIERCE, FL 34982
Legal Description: RUHLMAN S/D BLK 8 LOT 1 AND N 61.65 FT OF LOT 2 AND 45 FT STRIP LYG W OF AND ADJ
TO LOT 1 AND N 61.65 FT LOT 2 (.062 AC) (OR 2909-2303)
Property Tax ID #: 3403-805-0145-000-5 Lot No.
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
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INSTALLING NEW 100 AMP SINGLE PHASE SERVICE FOR GROUND SIGN.
HVAC " Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 2.220.00
Block No.
Gas Piping _ Shutters ❑ Windows/Doors
Sprinklers 11 Generator O Roof
S Ft. of First Floor: _
Utilities:n Sewer O septic
Building Height:
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Name CRAIG&LITZ HENDERSHOT LLC
Name: JOHN M. APPLEBEE
Add ress:5250 S US HWY 1
Company: JAK, INC. DBA APPLEBEE ELECTRIC
City: FT. PIERCE State; FL
Address: P.O. BOX15
Zip Code: 34982 Fax:
City: FT. PIERCE State: FL
Phone No. 772-252 48a2
Zip Code: 34954-0015 Fax: (772) 46"765
E-Mail:
Phone No. (772) 466-3970
Fill in fee simple Title Holder on next page (if different
E-Mail: APPLEBEEELECTRIC@BELLSOUTH.NET
State or County License: 19055
from the owner listed above)
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
02/26/2015 9:29 AM FAX 7724663765 APPLEBEE ELECTRIC 0003/0004
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DESIGNER ENGINEER:
Name:
Address:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
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:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permitto 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 Count 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. Lurie 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-resldential 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
STATE OF FLORIDA
COUNTY OF
The forgping instr ent was acknowled ed efore me
th.-tMiday of 2OUSJ by
Produced
Public Stele
159114
STATE OF FLORID
COUNTY OF
The fo ing instrurpen�was acknowledged efore me
thi day of 2OW by
Ppnro-naliy Knowrr•. OR Produced identification
of Sonia
My Commievion EE 159114
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COMPLETED