HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10-30-15 Permit Number:
- RECEIVE f
Building Permit Application
OCT 2 9 2015
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 X.
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 10851 S-Ocean Drive Lot 28
Legal Description: Windmill Village By The Sea
PropertyTax ID#: 4511-810-0035-000-2 Lot No. 28
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Replace bad RV power pedestal at existing location and reconnect to existing FPL service wire.
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Additional work to be nertnrmed mit—check all that appy:
1_1i.
HVAC _Gas Tank ❑Gas Piping Shutters Q Windows/Doors
QX_Electric Plumbing []Sprinklers ElGenerator 0 Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 600.00 Utilities: Sewer FiSeptic Building Height:
Name David A. Coates Name: Kenneth Geremia Jr.
Address: 65 Victoria St. Unit 44 Company: Gerelco Electrical I.
City; Manchester State: NH Address: 560 NW Enterprise Drive I
Zip Code: 03104 Fax: City: Port St Lucie State: FL {:
Phone No. 914-584-7400 Zip Code: 34986 Fax: 772-340-7475
E-Mail: loopn918@gmail.com Phone No. 772-340-7475
Fill in fee simple Title Holder on next page(if different E-Mail: bwillard(a)gerelco.com
from the Owner listed above) State or County License: EC 13003415
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If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
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DESIGN ER/ENG I NEER:
-- ---------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 HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable _
Name: Name:
Address: Address: =
City: City:
Zip: Phone: Zip: Phone:
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 attorney before
commencing,work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
before meed
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged �
this 30 day of October 20 15—b y this 30 day of October 20 15 by !:
(Name of personatknowledging) (Name of person nowledging)
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Lure of Notary Pub'c-State of Florida} (Si ure of Notary , ic-State of Florida)
Personally Known OR Produced identification Personally Known OR Produced Identification
Type of ldentificatio Produced Type of ldentiflcati n Produced
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�'"• TORI L WAR @n :; Y.^�++ TOJIMIWAR,
Commission No. 'E`• I�, mis ion No.
COMMISSION# F909394 •, MY COMMISSION#1=FW9'194 '
EXPIRES October 11 201-q
1407)39M 63 FlaidaNctaryService.com ,
Revised 07/15/2014 007)398-0 53 FioridallotaryService.cam
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS