HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO/ MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
C SCANNED
BY If`utz 4,,;�'t;`'
• . - St. Lucie County
Building Permit Application SUP! 16 26i
Planning and Development Services PERiJInTiNqG
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
PROPOSED IMPROVEMENT -LOCATION -
Address: Cinnamon Way &Id 1'a55 it -at
Legal Description: HARBOUR RIDGE -PLAT 3-TRACT L -17-LESS AS IN 06 698-1646 (6.00 AC) (OR 714-219: 1361-1125)
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Property Tax ID #: 4425-602-0006-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks , Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove (5) existing and provide and install (4) new lighting standards as specified with associated
concrete bases.
CONSTRUCTION INFORMATION: III
I_IHVAC L_J Gas Tank
UJ Electric ❑ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 15,000.00
Piping ❑_Shutters ❑Windows/Doors
nklers ❑ Generator ❑ Roof = Roof pitch
S Ft. of First Floor:
Utilities:Sewer ❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name lhoaanv,� V&, A **- 11Q:5PA
Name: Michael Dale Ault
Address:12600 NW Harbour Ridge Blvd
Company: Ault Brothers, Inc. Electrical Contractor
City: Palm City State: FL
Zip Code: 34990 Fax:
Phone No. it a-- 33(e- 3ma
Address: PO Box 1528
City: Port Salemo State: FL
Zip Code: 34992 Fax: 772-283-0321
Phone No. 772-283-5520
E-Mail: d. (,C-s�ceO (,—%4 41
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.
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 TITLEHOLDER: _ 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
STATE OF FLORA �C� J COUNTY OFOR A. I Q� COUNTY OF t STATE OF FIL
The for oing instrument was acknowledged before me The forgoing instr ment was acknowledged before me
this��ayof 11LAnA. 20 Llby this—ILL�4dayof try L 20 L y
to�n ] M11616-L 1-)� D,&�
(Name of person acknowledging) (Name of person acknowledging)
Notary Public- Stat of Florida ) (Signature of Notary Public -State cUlorlda )
Personally Known � OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced I Type of Identification Produced rL DL_
Commission No.
Revised 07/15/2014
HEATHER
EXPIRES:
No. p:T---1 D'0 1
HEATHER HARRINGTON
MYOOhMISSIONSFF9425
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