HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�1
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED pp ss-�
Date: (2' I,' I� G SCANNEuermit Number. �-1 o l0 _ o S 4�
St Lucie
i�l. i �m F-
• ucie County
Building Permit Application JUN 16 2017
Planning and Development Services PER:✓,ITTIfdG
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Electrical = III
PROPOSED IMPROVEMENT LOCATION: " - III
Address: NW Mariner Ct
Legal Description: HARBOUR RIDGE -PLAT 4-TRACT PA - 2(1.66 AC) (OR 920-161: 1361-1124)
Property Tax ID #: 4425-603-0004-000-6
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
Remove (7) existing and provide and install (8) new lighting standards as specified with associated
concrete bases.
CONSTRUCTION INFORMATION:
itiona wor to e�je orme un er this permit— c ec a apply:
OjI HVAC I Gas Tank Gas Piping _ Shutters ❑ Windows/Doors
Electric El Plumbing Sprinklers 11 Generator E]Roof = Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: S 30,000.00
S Ft. of First Floor:
Utilities:SewerElSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Named A' 04aZ ,iL vZU.A" VloA; .
Name: Michael Dale Ault
Address:12600 NW Harbour Ridge Blvd
Company: Ault Brothers, Inc. Electrical Contractor
City: Palm City State: FL
Zip Code: 34996 Fax:
Phone No. 7 7 D - 33(0- 3cK)b
Address: PO Box 1528
City: Port Salemo State: FL
Zip Code: 34992 Fax: 772-283-0321
Phone No. 772-283-5520
E-Mail: r�%�%synZG`/�r./(ZE.•CN'pi•
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: aultbros@yahoo.com
State or County License: EC0001693
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 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. 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
commencing work or recording vour Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S-F, llAC t3, COUNTYOF c,i-. IjAC.`2
The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this_112dayof ' e— 20 )Jby this �—Q day of ,20 ice' by
'bn'n vi�fL 0 \ Q- &.Q- k b(iLQ- DAAA-�-
(Name of person acknowledging) I (Name of person acknowledging)
(Signature of Notary Public- State of Flor ) (Signature of Notary Public -State of Wricla )
Personally Known OR Produced Identification Personally Known OR Produced Identification )`�7
Type of Identification Produced Type of Identification Produced_ _ FL It> L
Commission No. r r 94oa63
MY COMMISSION! Fff 942634
Bonded ThN
Revised 07/15/2014
No.
ERPIRES:
HARRINGTON
;ION 5 FF 942534
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
�y G
COMPLETE
INITIALS
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