HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: IM-7
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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 X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: 6501 S Ocean Drive , Jensen Beach, Fl 34957
Legal Description: 8/09/15/16/17/21/22 36 41 All Fract Secs Band 9 LYG W of Ala
less N436 .71 FT. and all fract sec 9 LYG E of AIA Less N 736 . 71 FT and all
PropertyTax ID#t: 3508-111-0002-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Installation of 20AMP Circuit.
Setbacks Front Back: Right Side: Left Side:
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Installation of 20AMP Circuit
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Iditional work to he� e orme 'r under this permit-check^ a appy:
HVAC E]Gas Tank OGas Piping _Shu11tters Windows/Doors
OX Electric 0 Plumbing Sprinklers 0 Generator 0 Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 13, 561. 00 Utilities:[]Sewer Septic Building Height:
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Name Florida Power and Light Co. Name: Tim Onnen
Address: 700 Universe Blvd. Company: Meisner Electric
City: Juno Beach State: FL Address: 220 NE 1st Street
Zip Code: 33408 Fax: City: Delray Beach State: FL
Phone No. (561) 301-3089 Zip Code: 33444 Fax: 56-278-8397
E-mail: eric.cesaretti@fpl.com PhoneNo.561-278-8362
Fill in fee simple Title Holder on next page(if different E-Mail: geofer@mei.cc
from the Owner listed above) State or County License: ECO000418
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
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Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: xNot Applicable
Name: Name: I
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 l
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
Thefollowing 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 berecordedand posted on the jobslte
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
bw P. evin P. Hughes SID., s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDQ� ) r
'COUNTY OF �d� � a�� CN COUNTY OF 'i�A M
E
The;forgoing instrument was acknowledged before me The forgping instrument w s acknowledged before me
this.497"bay of .JiJ1-V 20 Eby this day of. J 1���.i 20 IS by
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(Name of person acknowledging) (Name of per knowied Ing)
(Signature of Notary Public-State of Florida) (S' tur °o otary Public-Ate of Florida)
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Personally Known t/ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced
Type of Iden #t'ata 'Rr -. yp _
vo;;�., DENISE A.COMOLLI {'
°. a`°, Notal Public-St4fillorlda i Commission No.
Commission l3,.. Y �y�+ p pubib Seep of
• y omm.Expires May 4,2018 r Georpina F ndez
Flow
Commission# FF 111469 .: •�
,���•. MUMlt�rov,hNattortJNc'aryAssz:: -
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Revised 07/15 2014 " '
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