HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ws1 5 Permit Number:\
RECEIVED OCT 161015
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: 200 N El Mar Dr. — Bldg A
Legal Description: Section 11, Township 37, Range 41 Beg NW Cor of Lot 41 of Beach Club
Colony Sec 1
Property Tax ID#: 4511-512-0000-000-3 Lot No. 41
Site Plan Name: N/A Block No.
Project Name: N/A
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Secure existing cabling and encapsulate open/exposed junction boxes in attic area
CONSTRUCTION INFORMATION:
Additional work toa er orme under this permit—check a appy:
HVAC E]Gas Tank Gas Piping Shutters a Windows/Doors
Electric 0 Plumbing ]Sprinklers a Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1,000.00 Utilities:cnSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Beach Club Colony Condo Asso Inc Name: Michael Dale Ault
Address: 1100 N Homestead Rd Company: Ault Bros, Inc.
City: Lehigh Acres State: FL Address: PO Box 1528
Zip Code: 33936 Fax: City: Port Salerno State:FL
Phone No. Zip Code: 34992 Fax: 772-283-0321
E-Mail: Phone No. 772-283-5520
Fill in fee simple Title Holder on next page(if different E-Mail: aultbros@yahoo.com
from the Owner listed above) State or County License: EC0001693
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 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.
P A /n1' nw,iv, _�il D'c s
_Signature of Owner Lessee/Agent Sign dt Lif e of Con ractor icense �old e �— t
STATE OF FLORIDA STATE OF FLOTQA Lyc
COUNTY OF 5�. 1..y c\ COUNTY OF S� \e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this\<O day of 1 20 15 by WAG day of QC_�r 20 )-S by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pub ic-State of Flor rla- (Signature of Notary Pu ic-State of Florida
6�
Personally Known OR Pp "uc�e � en taa` s°% Personally Known OR Produced I eDkLf a�jjgE�
Type of Identification Producda' ��Q #�` ` a°`a` "` Type of Identification Produced L �EPN�� o 20 5
�, ��� „PSB,, �°acy P� E•�p��es� 85161
Commission No.C'- _' G° Commission No. 5 �.�; �( � 5\p0#EE`NGva� Psso
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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