HomeMy WebLinkAboutBuilding Permit Application Jan 0416 02:41 p CEI Electric Inc. 772-340-0560 p.3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 91/04/16 Permit Number:
Building Permit Application
Planning and Developm ent Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential XXX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P.R4POSED.111lfPR+O.VE°MEI T.LO.tA" IO:N.�._
Address: 3604 Avenue J-Ft.Pierce FL
Legal Description:
Property Tax ID#: 2405-701-0081-000-2 Lot No.16 wl12of 17
Site Plan Name: Block No. 41
Project Name: Sunland Gardens
Setbacks Front Back: Right Side: Left Side:
-DETAILEb'•DESCROP71ON.OF.:1NORX ::
Reenergize Power
CONS RW,CTION.11 FOR1Vt_ATiO.N: :.. .: ..'..
Additional work to UGas
e orme un er t is permit—c ec a aHVAC Tank E]Gas PipingnGenerator
Shutters FiWindows/Doors
Electric Q Plumbing Sprinklers Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$_ c2 oo . 00 Utilities: Sewer E]Septic Building Height:
OWN' 1ESSEE CONTRACTOR::.
Name David A. Birth Name: David A. Birth
Address:460 NW Concourse Place Ste 11 Company: Camouflage Electric Inc.
City: Pt St Lucie State:FL Address: 460 NW Concourse Place Ste 11
Zip Code: 34986 Fax:772-340-0560 City. Pt.St.Lucie State-FL
Phone No.772-340-0111 Zip Code: 34986 Fax: 772-340-0360
E-Mail:davidb@ceielectric.net Phone No. 772-340-0111
Fill in fee simple,Ttde Holder on next page(if different E-Mail: davidb@ceielectdc.net
from the Owner listed above) State or County License: E013001924
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Jan 0416 02:41p CEI Electric Inc. 772-340-0560 p.4
St�PFLEMT Ul'!Q! 11IIt.iNMATiON
DESIGNER/ENGINEER Not Applicable MORTGAGE COMPANY: Not Applicable
--- _
j Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: - Name:
Add ress• 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 an applicable Home Owners Association rules,-bylaws or and covenants that may restrict or prohibit such
structure. Please consult wylth 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 1 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.wQrk or recorWng your Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signatu o ractor/ se Holder
STATE OF FLORIDA •. STATE OF FLORIDA
COUNTY OF 5 � . L � � �- COUNTY OF 5.4 .
The for oing Instru ent was acknowledg efore me The f going instru ent was acknowledged before me
thisl�dayof� 'rir 20 by this �T--dayof Lta! 20 by
(Nam of person acknowiedgi g) (Na a of person acknowledging
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(Sign ure of NotaryPublic- to lorida) (*.Aaure of Notary Public-St to of da}
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No. 1� ip!'P4f.. (Sh T1N0 pEREZ
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