HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-z
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A • a. l li - Permit Number:
RECEIVED
Building Permit Application 12 Vt
Planning and Development Services FEB
Building and Code Regulation Division Pe�� CLu p coax Ment
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:
Legal Description:
Peacock Road
Property Tax ID #: 3212-131-0002-000-7
Site Plan Name:
Project Name:
Lot No.
Block No.
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Build 400 amp service with 2-200amp panels SCANNtU
Wire and install lights and receptacles /f� a r y ` BY
St. Luojo C®ynty
CONSTRUCTION INFORMATION: III
0HVAC U Gas Tank ❑Gas
Electric 0 Plumbing �Spr
Total Sq. Ft of Construction: r�
Cost of Construction: $ �J .
Piping UShutters ❑Windows/Doors
nklers 1:1 Generator U Roof = Roof pitch
S Ft. of First Floor: _
Utilities:ll Sewer U Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameAgricultural Air Services LLC
Name: Lawrence Stubbs
Address:3161 SE Chandelle Rd
Company: S&W Electric Inc.
City: Jupiter State:Fl
Zip Code: 33478-1909 Fax:
Phone No. G l — i � S U
Address: 501 W. Coker Rd
City: Ft Pierce State: FL
Zip Code: 34945 Fax: 464-4273
Phone No. 464-6466
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: stuboutelectric@aol.com
State or County License: 29442
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: _
Zip: Phone
Zip: _
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to 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 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
improvement54o your property. A Notice of Commencement must be r orded and posted on the jobsite
before the fKif inspection. If you intend to obtain financing, consult lender or an attorney before
commenciddwork or recorcilpig YoWNotice of Commencement.
gnature of Owner/ Lessee/Contractor as Agent fonsm
Signature of Contractor/License Holder
STATE OF FLORIQ r
STATE OF FLORIDjQ�
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COUNTY OF
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The forgoing instrum was acknowledged befor
�`n�g
The f oing instru ent was acknowledge efore
this dayofJ207by
'a,^'c�g
this�dayof � e/ 2Qgby
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Na a of perso aking statement
Name of pers� raking statement
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Personally nown OR Produced Identifi
Personally Known OR Produced Identifica
Type of Identification � j!�
Type of Identification
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Produced
Produced
�N
(Signature of N 06alvPublic- State of Florida)
(Signature awry Public- State of Florida
�—
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17