HomeMy WebLinkAboutBuilding Permit Application 07/08/2015 11:04AM FAX 7723372699 DENT–BLOSSER 0110002/0003
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial XX Residential
PERMIT APPLICATION FOR: Electrical
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Address: 10980 S Ocean Drive, JEnsen BEach, FI 34957
Legal Description:
Property Tax ID#: 4512-702-0000-000/9 Lot No.
Site Plan Name: Ocean Dune Block No.
Project Name: pool MEter
Setbacks Front Back: L,7 Right Side: Left Side: 4�
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Replacing 3 phase CT meter can.
kc1ditional
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HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing ❑Sprinklers 1:1Generator Roof
Total Sq. Ft of Construction: — $ . Ft.of f=irst Floor:
Cost of Construction:$ 1005.00 Utilities. Septic Building Height:
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NameOcean Dunes Condo Assoc. _ Name: Kent Blosser
Address:10980 S Ocean Dunes Company: Blosser Electric
City. JEnsen Beach State: FI Address: PO Box 7305
Zip Code: 34957 Fax: City: Port St Lucie State:Fl
Phone No.772-229-2244 Zip Code: 34985 Fax: 772-337-2699
E-Mail; Phone No. 772-337-0055
Fill in fee simple Title Molder on next page (if different E-Mail: nrblosser@gmail,corn
from the Owner listed above) State or County License: EC13001570
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
07/08/2015 11:04AM FAX 7723372699 KENT—BLOSSER Z0003/0003
!~SIGNER ENGINEER: Not Applicable
MORTGAGE
MORT
GAGE COMP
ANY, Not ApplicableName: Name:
Address: —
City: State: City,
Address: 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'.
I certify that no work or installation has commenced prior to the Issuance of a permit,
St.Lucie County makes any that is granting a permit will Uuthorize and
holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or anci 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.
Tho 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 0 ER: Your failure to Record a Notice of Commencement may reser 'n your paying twice for
to
improvements yo r property. A Notice of Commencement must be regarded __d posted
d on the jobsIt'.
I . ins .
t in_P.i
before the fi ins ction. if you intend to obtain financing, consult with lender an attornpY before
commen, . g wor or recordingAOr Notice of Commencement,, .,,-
_g
25� mar
Signature of Owner/Lessee/Agent 54gti�ature_of Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY 01 6"r_ COUNTY OF 3E
The forgoing Instrument was acknowledged before me The forgoing Ins'trumpnt was acknowledged before me
this 24juy of_j"A ji-i- 20/5 by thisAef day of 20 by
SW t 7F,1 A
Nil
r
(Name of persqn ac nowledgin (Name of person acknowledging)
t5A V IT�2
(Signature of Notary Public-Stisti of Florida ) (Signature of Notary Public-State of Florida
Persunally Known_Z'QR Produced identification Personally Known__.��OR Produced identification
Type of Identification Pro ype of identification Produced
$AVITRI M.OA:RGIA
(I of 11RI.M.GARCIA
c FloridaCommission No. state of Florida ommission No.
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My Comm,Expires Apr 1.2016 Notary Pu state of Flod
mycomm
Expirps Apr 1,2016
Commission # EE 185187
commissloff-*EE i W
CP W Mur 9P
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETE
INITIALS