HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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: 4844 S Jenkins Rd#CATV
Legal Description: ROW est of S Jenkins Rd @ Environmental Dr
Property Tax ID#: 3406-502-0010-9999 Lot No.
Site Plan Name: Block No.
Project Name: Comcast Power'Supply- Packers of Indian River
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install new Comcast power supply cabinet on the south side and in line with-FPL pole located
approx 865 ft north of W Midway Rd across from Environmental Dr
CONSTRUCTION INFORMATION:
Acialtional work to be ertormed under this permit—check all appy:
HVAC L_J Gas Tank []Gas Piping _Shutters ❑Windows/Doors
✓Electric 0 Plumbing 0-Sprinklers El Generator EI Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction: $ 722 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Comcast Name: Gary J Gifford
Address: 10435 Ironwood Rd Company: Gary J Gifford, Inc.
City: Palm Beach'Gardens State:FL Address: 350 SW Linden St
Zip Code: 33410 Fax: City:.,S.tuart State:FL
Phone No. Zip Code: 34997,.. Fax: 772-219-0146
E-Mail: Phone No. 772-286-0.954'
Fill in fee simple Title Holder on next page(.if different E-Mail: giffelec@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.
SUPT, ,EMENTAL CONSTRUCTION;LIEN LAWN INFOR ATION
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:
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 of recording our Notice of Commencement.
Signature of Owner/AjenV_LessqV Signature of Contractor/License Holder
STATE OF FLORIDA . STATE OF FLORIDA
COUNTY OF iP.� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thi D day of OV 20 b this'o�day of tom/ 20�JS by
crn_r"A �� ` v�
(Name of perso cknowledging) (Name of person ack4owledging)
gnature of Notary Publi - tate of Florida) (Signature of Notary Public-State lorida)
Personally Known OR Produced Identification Personally Known OR Produced Identification el
Ti a of Identi ication Produced Type of Identification Produced
Commission No. Seal) Commission No. a
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REVIEWS FRONT SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS