HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO M9,ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �
Date: �� O + afo
�� r l�� Permit Number: — (,1�
MAY 2 8 2015
BuildingPermit Application
PERMIT JG
Planning and Development Services St. Lucie County, FL
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION:
Address: 10001 W.ANGLE RD, FORT PIERCE;FL 34945
Legal Description: 3 35 39 NW 1/4-LESS AVON MANOR-UNITS 1 AND 2 AND LESS W 615.5 FT LYG S OF AVON MAONR-UNIT 1
AND LESS CANAL AND RD RSM AND LESS 1-95 AS IN OR 237-1372-(99.02 AC)(OR 630-131)
Property Tax ID#: 2303-211=0025-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: _ }. R
CLUBHOUSE: REMOVE EXISTING ALUMINUM FEEDERS AND REPLACE WITH COPPER.
CONSTRUCTION INFORMATION: ^
Additional wor to be nertormed under tispermit—check all appy:
HVAC Gas Tank E:]Gas Piping _Shutters Q Windows/Doors
ZElectric Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of.Construction:$ 9,985.00 Utilities:In Sewer Septic Building Height:
OWNERAESSEE: " C0NTRACTOR:
Name PERSHING MOBILE HOME SALES,INC. Name: JOHN M.APPLEBEE
Address:901 N.W.31 ST AVE. Company: JAK, INC. DBAAPPLEBEE ELECTRIC
City: POMPANO BCH State:FL Address: P. O. BOX 15
Zip Code: 33069-1100 Fax: City: FT. PIERCE State:FL
Phone No.772 465-8006 Zip Code: 34954-0015 Fax: (772)466-3765
E-Mail: Phone No. (772)466-3970
Fill in fee simple Title Holder on next page(if different E-Mail: APPLEBEEELECTRIC@BELLSOUTH.NET
from the Owner listed above) State or County License: 19055
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIONLIEN LAW INFORMATION:
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:
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
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
con3mepcing work or recording our Notice of Commence
aS nature o Owned gent/Lesleg i -nature ;Contractor/Licens H &der
A
S OF FLORID ST'IiOF FLORI
COUNTY OF COUNTY OF
The fogging in ument was acknowledged before me The for oing instrument was acknowledged before me
this day of 206y this day of 20�i by
%0", y x0j,
(N a of person acknowledging (. of person acknowledging)
(Signature of Notary Pub' -State of Florida) (Signature of Notary Public- to o lorida)
Personally Known t., Personally Known i� �ntif�ctton
Type of Identifica -State of Florida
Type of Identification QdJu DAWN MILD F
_• • = =?• la�: Notary Public-state of Florida
My Comm.Expires Mar 22,2017 ,•
Commission No., ss,• •oma: EE 877571 Commission No. •r.r '-MY C0 fres Mar 22,2017
Commist§je®f �
Bonded Through National Notary Assn. :;soF F`oa��.' Commission#EE 877571
Bonded Through National Notary
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED