HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -
Date: 12-30-2015 Permit Number:--� —�
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' 1100111PNOMW Building Permit Application DEC 31 2015
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, Fl-
2300
L2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 ComirerCiE I XXXXXXXX Residential
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PERMIT APPLICATION FOR: EfeddGal
PROPOSLD IMPROVEMENT LOCATION:
Address: 2799 N US Hwy 1
Legal Description. S/D RUSSELL ESTATES 28 34 40 TRACT LYG S OF ST LUCIE BV AND W OF sr 5 IN LOT1 S?D OF RUSSELL
ESTATES-LESS US 1 AS DBKI-33(OR 1590-2005)
PropertyTi:,x ID#: 1428-501-0022-000-5 Lot No.1
Site Pian Name: Block No.
Project Narne: SUPER STOP PETROLEUM INC
Setbacks Front Back: Right Side: `Left Side:
DETAILED DESCRIPTION OF WORK:
WIRING OF KITCHEN HOOD SYSTEM,WITH 1 120 EXI-AUST FAN, 1 120V SUPPLYIMACKE UP AIR
FAN, HO(DHD LIGHTS, TEMPRATURE SENSOR, FIRE F ORN AND CONTROL CIRCUIT.ALL
ELECTRIC UNDER HOOD CUTS OFF WHEN SYSTEM 1c;I ACTIVATED.
R& R SHETMATAL INSTALL PERMIT SLC 1506-0111
CONSTRUCTION INFORMATION:'
Additional wowt0t)epertormed un ert ispermit—c ec K all appy:
HVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric 11 Plumbing Sprinklers Ci Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1800.00 Utilities"ff Sewer Septic Building Height:
OWN ERAESSEE: CONTRACTOR-. .
Name SUPER STOP PETROLEUM,INC. Name: JAMES M ROWELL
Address:62-21 W ATLANTIC BLVD Company: DBA JIMMY ROWELL ELECT51kIC SERVICE
City: MARGATE State:FL Add ess: PO BOX 2262
Zip Code: 33063 Fax: City: STUART State:Fl-
Phone
LPhone No.954-907-9945 Zip Code: 34995-2262 Fax: 772-220-2755
E-Mail: Phone No. 772-220-8880
Fill in fee simple Title Holder on next page(if different E-Kill: JROWELLELECTRIC(P_AOLCOM
from the Owner listed above) Stag:or County License: EC-13002740
If value of construction is$2500 or more,a RECORDED Notice of Comm mcement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN'LAW INFORMATION:
DESIGNER/ENGINEER: Y�Not Applicable MDRTGAGE COMPANY: Not Applicable
Name: Mime:
Address: Address:
City: State: :p: State:
Zip: Phone: ZilK Phone:
FEE SIMPLE TITLE HOLDER: 'X Not Applicable i BONDING COMPANY: _XNot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to,the issuar ce of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to bund 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 al;ree 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 your Notice of Commencerr ent.
S
Pnature of Owner/Lessee/Agent s�*Eure of Contra ctor/License Holder
STATE OF FLORIDA a_ E OF FLORIDA
COUNTY or- -iMJ'- ZZ
MG 0 COU NTY OF
Theing instrument as acknowledged before me The f)rgoing instrument was acknowledged before me
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this ail�ldaycif 20 Eby this e 201 r by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida (sign iture of Notary Public-State of Florida
Personally Known L--— OR Produced Identification Persosally Known L--'•� OR Produced Identification_
Type of Identification Produced Type of Identification Produce
Commission NO. Ef -7
TE ESA L SENNIGAN .,,omniission No,.
TERESA L BEINNIGAN
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REVIEWS FRONT ZONING SUPERVISOR PLAP S VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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