HomeMy WebLinkAboutBuilding Permit Application Miranda Plumbing&AC 7728710863 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date: permit Number:
RECIEW'D DEC 03 2015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:J772)462-1553 Fax: (M)462-1578 Commercial Residential xxxxx
PERMIT APPLICATION FOR; Electrical
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Address: 3400 Feriwinkle Court
Legal Description: SAVANNA CLUB PLAT THREE ELK 30 LOT 36 (OR 3469-699)
Property lax lD#: 3425-703-0351-000-7 Lot No.
Site Plan Name: Block No.
Project Name:John Sam!68
Setbacks Front Back: Right Side: Left Side:
Two receptacle circuit extensions in florida room
7771
Additionalworktobegertormed under this permit—check all that apply:
0HVAC F]Gas Tank [:]Gas Piping 1-1 Shutters Windows/Doors
FlElectric 1:1 Plumbing nSprinklers L2GeneratorRoof
Total Sq.Ft of Construction: Scl. Ft.of First Floor:
Cost of Construction:$ 750.00 Utilities: Sewer Septic Building Height:
ri GR
Name Barbara Weltsek Name: Don Miranda
Addre5s:3400 FeriNvinkle Court Company: My Electrician
City: Port St Lucie State:FL Address. 750 Nk/V Enterprise Drive
Zip Code: 34986 Fax: City, Port St Lucie State:FL
Phone No.772-807-1633 Zip Code: 34986 Fax: 772-871-0863
E-Mail: Phone No. 772-878-6123
Fill in fee simple Title Holder on next page if different E-Mail: Ldiodato@?mirandacompariles.com
from the Owner listed above) State or County License: ECI 3003398
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Miranda Plumbing&AC 7728710863 p.3
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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,
accessary 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' pection. If you intend to obtain financing,cons" or an attorney before
pl`�
co In work or re in your Notice of Commencement.
S
Signature of Owner/Lessee/Agent Signature of Contractor/LicensTrTolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_day of , 20 —by this day of 20 by
(Name�10 rson ac ledging person njwledging)
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(Signature of Notary Public-State of Florida (Signature of Notary Public-State of Florida
Personally Known LXX, OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced I ori Dindato
Ori to a U0ymmioN#EE856794
Commission No. ?M MISSION#EE 856794 Commission No.EE P)REs:FEE.09,2017
-EXPIRES:FEB.09,2017 tam wwwAARONNOTARYCOM
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