HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB E INF MMUT BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� LS1j,5— Permit Number: I�
.rte;� „-,�T.,���,.,.-�;��-..�� •
•
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: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 5401 Buchanan Dr#CATV
Legal Description: ROW- SW corner of Buchanan Dr &Howard St
Property Tax ID#: 3402-602-0193-9999 Lot No.
Site Plan Name:— Block No.
Project Name: Comcast Power Supply
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install new Comcast post mount power supply cabinet on the south side and in line with.FPL pole
located approx 13 ft west of Buchanan Dr, 20 ft south of Howard St
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
ZElectric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of,Construction:$ 722 Utilities: Sewer Septic Building Height:
OWNER/LESSEE! ,,..._ CONTRA' T3R:
{,, ,,
Name Comcast Name: Garr J:}Gifford'
Address:10435 Ironwood Rd
Company: J,Gifford, In
c:
City: Palm Beach Gardens , StAe.F Address: 360 SW Linden,St,.
33410 ,� i . F e�;�-�... ..,x�.,�..,:y:::}
Zip Code: Fax: City: Stuart State: FL
Phone No. � ��(� S Zip Code: 34997 Fax: 772-219-0146
E-Mail: Phone No. 772-286-0954
Fill in fee simple Title Holder on next page(if different E-Mail: 9iffelec@comcast.net
from the Owner listed above) State or County License: 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 BOLDER: X Not Applicable BONDING COMPANY: X 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 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.
Signature of Owner A t/Less Signature of Cc_ntre96R6/en47,ro
STATE COUNTY
OFORIDAS STATE OF FLORIDA Luc
� Coy\ � COUNTY OF
The f oing instrum t was acknowledged before me The forgo01 instrum nt was acknowledged J2efore me
this day of20, b this day of 20 by
(Name of person ack1ho ledging) (Name of person ackno le ging) VI
(Signature of rolary Public-S to of Florida (Signature of Noary ubli:12R.2rciduw
tate of lorida
Personally ovyraR��c� Persona o nidtion
Type of Ider t' `� : oc} g H Type �� ion Pro
.�`a�'v aye.
i +' Commisslcn#►'F 234�30 `+° ` Notary Public-State of Florida
Commissiori f@N¢.E `� Expbes �17,201fi Com 5 ;• Commission#FF 23473p$e )
Bonded through NatlonalNota►YAssn. ',,���o",opA;= My Comm.Expires May 27,2019
Bonded thr National Notary Assn.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS