HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �41JgOD alonj •}S Permit Number:
�INAIH'10 RECEIVED
BY
Building Permit Applitaftflotinty OCT 19 2016
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Luce i
i County.
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: r
Legal Description: A 5 g C
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Property Tax ID @; �� ' ��(C Cn((17 o600 p003 Lot No.
Site Plan Name: 8 Block No.
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Project Name: �� n✓JdM-a ✓/ _( 4 (LO,le&yusr ! oG4--
Setbacks Front Back: Right Side: LeftSlde:
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I Iona wor to a er orme un ert Is perm -c ec a apply:
DHVAC Gas Tank ❑Gas Piping In _Shutters ❑Windows/Doors
Electric Plumbing []Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ /a, /Q7.Ob Utilitles:12Sewer OSeptic Building Height:
0 7 rK1,12
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Name t,o. rQ 0v^4, 1),\ o Ca
Name: JAMES P WILLIAMS
Address: $*'a\ He`i
Company: ARLINGTON ELECTRIC
City: 'Q S t- State:
Address: 3251 SE DIXIE HWY
City: STUART State: FL
Zip Code:Fax:
Phone No.
Zip Code: 34997 Fax: 772-287-2380
E-Mail:
Phone No.772-287-1353
Fill In fee simple Title Holder on next page ( If different
E-Mail:grecig@arlingtonelectricinc.com
from the Owner listed above)
State or County License: EC0000127
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required. '
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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
BONDING COMPANY:
_Not Applicable
Name:
Name:
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 represegtation that is granting a permit will authorize the permit holder to build the subiect sttructure
which Is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or p4rlbit 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 )obsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
mac. r C/C -�� s
�31gnature f Owner/ Lessee/Agent Sign ure C(/�- i(L�l. ontractor/License Holder
STATE OF FLORIDA
COUNTY OF � - G�cr
The forgoing instrument was acknowledged before me
thlsZ'9 dayof OCTtiP 20 91by
1 ,
person
STATE OF FLORID/ I/kl
COUNTY OF M
The ff r In nstrumen as acknowledp��adbef Ye me
this da of 20 b
!PQ LJ4 A -A- S
(NaMe, f'iersonacknowledging)
0
( iture of Notary blic- State of Florida 14Signature Not
rsonally Known PC oury Prodc d Identifi cation ^^ Personallyof Known
Type of IdentificationPe elflcai
Commission N FF 23129Commission No.ES a4� C mission No. Q mnussmn Ex{me`,;;,;,;°��' May 17. 2019
Revised 07/15/2014
Commission n FF 38793
Bonded ThiixSP0l)iiona1 nolaryAssn.
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS