HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INf S GO_RATED FOR APPLICATION TO BE ACCEPTED
Date: ��/ Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pieree FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial x Resi'dent'ial
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 25-A Azul St#CATV
S anishl Laktes'
Legal Description: N
Property Tax ID#: 1301-111-0001-0005 Lot No.
Site Plan Name: Block No.
D.rninr+Kl�mo.; .Comcast Power Supply No-de.FP 025
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIRTION,�, WORK
Install new Comcast power supply cabinet 115 ft east of Azul St between lots 25 & 27 next to FPL
pole 6 6083 0553 06, remove damaged cabinet when new is energized
CONSTRUCTION INFORMATION:
Additional work toewe orme under this permit—check a appy: ^
UHVAC U Gas Tank uGas Piping U Shutters I__.l Windows/Doors
Electric 0 Plumbing Sprinklers []Generator E]Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 722 Utilities: Sewer❑Septic Building Height:
GINNER/LESSEE CONTA/1CT98-, _
Name Comcast Name:
Ga 'J'Gifford'
Address:10435;lronwood'Rd Company: Gary,J Gifiord,''Inc. n
City: Palm Beach`Gatdpris., State:FIL Address: 350'SW`Linden•St.,v = '!
Zip Code:,33410� ', ^" Fax: _ City: Stuart State FL
Phone No. � 1 Zip Code: 34997 Fax:'772-219-0146
E-Mail: Phone No. 772-286-0954
Fill in fee i ImpleTitle Holder on next page(if different E-Mail, giffelec@comcast.net
.frnm-the Aurnnr_licfnd ahnyoly I Ct�tc.nr_rn�nt�r-Li�nncc• EC13001574
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
KinmA• 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,
d\.A-c»u1yx1 ULLUfCs,Zwunnun6 JJ ICII\.C],wain,�Igi15,screen Iuuuu m1u accessary uses w m117u1cI uun 1csIucuual ux
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying:twice for
improve ents to your property.A Notice of Commencement must be recorded and posted on the jobsite
before t e first inspection. If you intend to obtain financing,consult w' h lender or an a rney before
comm cin wok or ec r In our Notice of Commencement.
A( . - I J&J"'�w 11
atureer A nt RLeAeeSignat of r ctor/License Holder
STATE OF FLORIDA C� STATE OF FLORIDA l
COUNTY OF _ COUNTY OF
Tho fnranina in®*rn ent;x;ve_��4nmAll-10-1 hcfnrc mo The f going instrgment was acknowledged.before me
a a,.....,,. - .,,_I.-d...,,.,,..�.,.
thi ay of 20 14 b this_gay of 20_jA by
Gk
(Name of person ackno)vledging) (Name of person acknowl dging)
TY),
C-,\
(Signature of Notay i)blit-State of Florida) (Signature of Not y ublic=State of Florida)
Personally Known OR Pr d Id_ till atio Personally Known a Id fication
Type of Identifi +. Type of Identificati gt tl
`4`�,`V P14 f" � � Notar M HUFF
Commission No ::° °: Notary Pub aa��t��ate of Florida a °� Y PuWr 1 to
ommiss�on 3WFF 234730 Commission ivo. ••e a'1 to of Florida
Tc CommiS�s3onr FF 234730
�• lt 27 2f
�, M P sMa
3 0;= My comm.Expires May 27,2019 % �nY Comm.Ex Ire
„i;,,.•`` Bonde t roll n - a io
9 e� nalNotazyAssn
Revised 07/1
nr\/IE A/r rn/�nIT �/"\uiPhlr f9 lnrn\/Ir/'1n nl A41r \9r/"`rTnTl/'1PI nTURTLE -
II non p1l"1'\A\/r
nCVIVVJ rnV1Vl LVINIllmu .ivrCnVIJVn PLHIVJ- If LuLlNl'IVtu Jr
ITLlnTnI CC• MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS