HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI�
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 31a5 � Is Permit Number: �5d3'Oy y
3 i , - -- --1 RECEIV'D MARI 5 BE
SCANNED
BY
Building Permit Application St. Luce Countv
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 x Residential
PERMIT APPLICATION FOR: Electrical III
IN AWJ UVM i OR IV/IJ iNlT1m1 VII a LIN INEW1NF!\■I®Ill ll
Address: 4999 Dunn Rd #CATV, Fort Pierce
Legal Description: ROW
Property Tax ID#: - 3440 3 —50.7• ofSf —qqq _9 Lot No.
Site Plan Name: Block No.
Project Name: Comcast Power Supply - Node SLO47
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION.OF WORK:
Install new Comcast power supply cabinet 4 ft north of concrete FPL pole located 20 ft north of
Midway Rd and 20 ft west of Dunn Rd in ROW
_J Gas Tank UGas Piping
OPlumbing ❑Sprinklers
Total Sq. Ft of Construction:
Cost,of Construction: $ 722
*..
Shutters ❑ Windows/Doors
Generator El Roof
S Ft?ofsFirstFloor:_
C
Utilities -IS Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR.
NameComcaet ;- -__Y 86
Name: Gary JGiffdrdw/
Address. 10435 Ironwood Rd. ',. _ a
Company: Gary J Gifford, rit.
City: Palm Beach Gardens '' ; ... r; State:FIL
Zip Code: 33410 -z Fax: L
Phone No. '
Address: 350 SW Linden.St , If
City: Stuart } State: FL
Zip Code: 34997 ~'" Fax: 772-219-0146
Phone No. 772-286-0954
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above) I
E-Mail: 9iffelec@comcast.net
State or County License: EC13001574
it value or construction is $25DD or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY:
Name:
=Not Applicable
Address:
Address:
City: State: _
Zip: Phone:
City:
Zip: Phone:
— State:
_
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
x 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 tidild 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 fallowing 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, consulywith lender or an attorney before
commencine work or recordinla vouv Notice of Commencement. / 1 /1 r
STATE OF FLORIDA I STATE OF FLOR p
COUNTY OF S )r • t V C \� COUNTY OF t- • 1-y c t
The going instrument was acknowledged before me The for oing Instrument was acknowledged before me
thisa`5day ofNngcc2015b this day of9�A0,r'20_fiby
Go.V:A 'G:�- -�:n-ex GAcij cv-�Grl
(Name of pers n acknowledging) (Name of�owledging )
(Signature of Notary Public- State of Florida 1 _.�E . cto� _s, (Signature of Notary blic- State of Florida) _
Personally Known
OR Pro u dl(<ratlg0°0_��a�61P
rsonally Known OR Pro
uced '
Type of Identification Produced lot- Q tP At &O
ype of Identification Produced
oNP t 1 Ft°
Y,
Commission No. E�
......... N t,O!,;X50 0 0o*
; ;•_Ft j`m OOS�
I
C,ominission No. .• P7 �>
Q 'DUC 0 16.
N°ts, b(50�l�es EESSS161ssn
p
NIA1
Comm�ss �NaupOa\N°ta�Y
Revised07/15/2014
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER`'
REVIEW
REVIEW
REVIEW
REVIEW`
REVIEW
REVIEW
DATE
COMPLETE
INITIALS