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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � 2 Date: r2• 1-5 17 - Permit Number: Building Permit Application RECEIVEF Planning and Development Services DEC 15 2015 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: 3503 AVENUE NORTH, FORT PIERCE, "Mk PIERCE, FIL 1 Legal Description: 5V0kA 3A G 2� y04 Z ©. 1,3 k) -OL 153,?-�c 15 Rk� Property Tax ID#: o� 6©� o i"S �� ©©� - 5 Lot No. Z Site Plan Name: Block No. Z4 Project Name: J'kQO�f., Setbacks Front Back: Right Side: Left Side: DETAILfD,DESCRIRTION OF WORK j CONSTRUCTION INFORMATION:- Additional NFORMATION:A itiona work to be nertormed un er t is permit-check all appy: HVAC Gas Tank E]Gas Piping _Shutters Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: I 114 S . Ft. of First Floor: Cost of Construction:$ 5CO UtilitieslnSewer 9Septic Building Height: OWNER/LESSEE.. -CONTRACTOR: Name`b5 A Qoo"- (2 StwiIAln Name: ROBERT KOENEKAMP Address:3503 �l�QP_ 1J Company: EAST OCEAN ELECTRIC OF FLORIDA, INC City: JrOQi P ie@C. State:_ Address: 3550 NW 8th AVENUE, Zip Code:314<k 4�17 Fax: City: POMPANO BEACH State:FL Phone No. '�'4 Z-C1 'A G R Zip Code: 33064 Fax: 561-228-8374 E-Mail: Phone No. 561-889-0607 Fill in fee simple Title Holder on next page(if different E-Mail: eastoceane@yahoo.com from the Owner listed above) State or County License: EC 0000187 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ZN ."r.,s"s`34 5 a.-:.tyr :. . jF„,.,ai . Pt.EV# # "ALCC3NS,r.R T#flr��1�J1 R A �N Tt�.,t..,Tbr✓;.4•i7. tv�J;-0"`,"!&', -4: :E� .,3:.. \ N. sl:. f•+ �i•; '4n ��. ':a�'.t..y.R,(�"'� �.���:�rm"�r•.s'r�ea�:r.�:a,�>> r��xd.' '�t..c, =sri ���Y„�;r:.�f1 ,��a.: r'��` ��yscn ,��r is,xs,��k'.b�'�trr�sl.;�:;' � a�,u'.atiS�.�.�'t�� 4?4'�, r �,?=G��f_”�c`:�.;�"�.F€?�as'�3��'�����6��ti'� DESIGNER/ENGINEER: Not A licable PP MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: 8 City: State: City: State: Zip:_ Phone: "Zip: one: Or FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: Ii 3 I 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 cin the jobsite before the first inspection. If you intend to obto financing,consult with lender or an attorney bef e commen ' work or r ordin ft Notice o; ommen ement. r� 4 S Si tore Owner/Lessee/Ag nt Sign ore of Contractor/Li ease Hoiden . STATE OF FLORI &J STATE OF FLORIDA COUNTY OF COUNTY OFPALM BEACH The fo oing instru ent was ackn wledged before me The forg*instrument w s acknowledged before me this day of. ' DA P O by this -day of 20 _by ROBERT KOENEKAMP (Name of person acknowledging) (Name of person acknowledging) (Sighdture,,A Notary Public-State of Florida) (Signatur Notary Public-State of Florida) Personally Known -OR Pro Identificati Personally Known OR Produced I n i ation Type of Identification Produced Type of Identification Produced Commission No. �•��Y'P I �A FLORES ""��t'"' INGRI ,F� RES -State of,Florida Commission No. "��"Y°6 . ;z°. *;°`'s Notary Pubtt� . 2aIy c „ * otary Public-Sta a of Florida •; *'- comm-Expires Sep 12, S My Comm.Expires Sep 12,2417 �J � °e CommiSs '�q+o�n�•`'` 'Ea fyx• Revised 07/15/201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS