HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: 10 31 1� SCANNED Permit Number: M 0
11111111116
By
St. Lucie County RECEIVED
Building Permit Application
Planning and DevelopmentServices OCT 3 12018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County, PBrmlttin3
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 4560 S 25TH STREET
Legal Description: 33 3540 SW 1l2 OF SW 114-LESS N 800 FT AND LESS W 40 FT AND LESS S 78FT AND LESS THAT PART FOR ADDN RD RfW MPDAF:....
Property Tax ID #: 2433-333-0001-000-6
Lot No.
Site Plan Name:
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
BUILDING NEW 100 AMP, SINGLE PHASE SERVICE FOR POST LIGHTING, GATE OPERATORS
AND PARKING AREA LIGHTING.
CONSTRUCTION INFORMATION:
Additional work to be ne ormed under tispermit—check all
11HVAC Gas Tank ❑Gas Piping
Z✓ Electric 0 Plumbing []Sprinklers
Total Sq. Ft of Construction: S
Cost of Construction: $ 9,000.00 Utilities:
appy-
_ Shutters
Generator
Ft. of First Floor:
Sewer 1:1Septic
❑ Windows/Doors
Roof Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ITALIAN CASTLE OF THE TREASURE COAST LLC
Name: JOHN K APPLEBEE
Address:3389 SHERIDAN ST #471
Company: ,IAK, INC. dlb/a APPLEBEE ELECTRIC
City: HOLLYWOOD State: FL
Zip Code: 33021-3606 Fax:
Phone No. (678) 938-1542
Address: P.O. BOX 15
City: FT. PIERCE State: FL
Zip Code: 34954-0015 Fax: (772) 466-3765
Phone No. (772)466-7930
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: APPLEBEEELECTRIC@BELLSOUTH.NET
State or County License: EC #0002956
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone:
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
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 holderto 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
com of rig work or recording vour Notice of Commencemeet,
S=hature wner/ Lessee/ o ra or as Agent for Owner
Sig tureof ontractor/License HUldell
LORIDA
S ATE OF LORIDA
COUNTY OF cTivae
C N OF sT.U1cIE
The forgoing instrum@@nt was acknowledged before me
this: day of ��W�+r 2018 by
he forgoing instrufsI�eln was acknowledged before
hisal day of l�e§O�io� 2018 by
me
JOHN M. APPLEBEE
JOHN M. APPLEBEE
Name of person making statement
Name of person making statement
Personally Known X OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification Produced
Type of Identification Produced
- \Cc3V
(Signat a of Notary Publi -State.,Uf.,FloricIMLISSAPARRAMORE
Notary Public -State of Florida
�.••31) commission l GG 126946
:;�� M Comm.Expires Jul 23,2021
Commission No. �' Y
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"•.,,,,`, �;:.••• 9:rdatl Mrou3h Natlonal Norory Assn.
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signatutle of Notary Public -State of Florida)
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Commission No. GG196946 •,12a. •.
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MELISSA PAAAAMOAE
NotaryPublic-StateufFlo
Commission lGG 126
My Comm. EAplreslul 23,2
WdedthmghNaJ1onalNWry
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Rev.8/2/17