HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/11/2015 Permit Number:
• LC +/ A
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)46271553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED INPROVEMENT LOCATION: "f
Address: 25700 ORANGE.AVENUE
Legal Description: 11 35 37 ALL AREAS DESIG CANAL R/2 AS IN OR 366-806 INCLUDING AS IN OR 821-163:
Property Tax ID#: 2111-111-0001-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REBUILT CANKER SPRAY STATION ELECTRICAL SERVICE DAMAGED BY VEHICLE.
CONSTRUCTION INFORMATION: -
Additional work toe e orme under this permit—check a appy:
[]HVACE] Gas Tank Das Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing OSprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: 00 S Ft. of First Floor*
of Construction:$ ��,00 Utilities: _Sewer. ❑Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name ORANGE AVENUE CITRUS GROWERS ASSN Name: JOHN M.APPLEBEE
Address:P O BOX 643820 Company: JAK, INC. DBA APPLEBEE ELECTRIC
City: VERO BEACH' State:FL Address: P. O. BOX 15
Zip Code: 32964 Fax: City: FT. PIERCE State:FL
Phone No.(772)201-2680 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 CONSTRUCTION LIEN 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
commencing work or recording our Notice of Commencement.
Si ature Owner/Agent/L ss a Si nature o Contractor/Licens H Ider
ST FLORI STA F FLORIDA
COUNTY OF COUNTY OF
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this t t� day of 20 by this day of 20=by
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