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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ) Date: Permit Number: i6io " J. • 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 Residential _ PERMIT APPLICATION FOR: Electrical -` PROPOSED IMPROVEMENT LOCATION: Address: 2_006 IQ InC'e EL Legal Description: Property Tax ID#: 14� 2• b (o Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTI�ON'OF'WORK. "'�, CONSTRUCTION INFORMATION: Additional work to be nertormed under t ispermit—check all appy: HVAC Gas Tank E]Gas Piping _Shutters a Windows/Doors Electric Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ ��) Utilities: Sewer[]Septic Building Height: OWNER/LESSEE: .;. CONTRACTOR: Name Loa-)(p �� Me Name: Robert Koenekamp Address:200 7s D\1- Company: East Ocean Electric Of Florida, INC City: State:_ Address: 3550 NW 8th Avenue, Unit 305 Zip Coder 1 ..;_- Fax: = ' �i City: Pompano Beach, FL Phone No.36 .Z O.,' lQzZ Zip Code: 33064-3008 Fax: 561-228-8374 E-Mail:.._ fA.,:=.::r,:-:: -. . K; r, Phone No. 561-502-9673 Fill in fee simple Title Holder on next page(if different E-Mail: eastoceane@yahoo.com from the Owner listed above) State or County License: EC 0000187 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: 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 thepermit 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 attorey before commencing work or recordin our Notice of Commencement. s _Signature of Owner/Lessee/Agent S•gnature of Contr for/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S�'1.,. ,� COUNTY OF PALM BEACH The forgoing instrumerIt was acknowledged before me The forgoing instrument a nowledged before me this �- day of 20�by thisG Ray of 20 PS by If\E7 -eW ROBERT KOENEKAMP (Name of person acknowledging) (Name of person acknowledging) �A &Li (Sign ure of Notary Public-Sarate of Florida) (Signature of tary Public-State of Florida) Personally Known OR Produ ed Identification Personally Known OR Prod ce dentification Type of Identification Produced Type of Identification P odu ed Commission No. L NA INGRAM Commission No [ I— (S © ea 1) e 2�, **�: Notary Public-State of Florida / Y .���"arP�e°�. INGRIS A.FLORES Expires DM; U.Zulu ?,« Notary Pub llc-State of Florida ,X oFJ Commission#FF 177249 . My Comm.Expires Sep 12,2017 Revised 07/15/2014' "' Bonded through National Notary Assn. :° commission#FF 039856 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE _T INITIALS