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HomeMy WebLinkAboutBuilding Permit Application 7 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 01/11/2016Permit Number: ��O --- �_ ; . "_4, JAN 121016 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 Residential PERMIT APPLICATION FOR: Electrical PROPOSED IMPROVEMENT LOCATION: Address: 3503 Avenue North, Fort Pierce, FL 34947 Legal Description: oB9 Ac 0 t - 335 - (sc Property Tax ID#: �'1' ©� © � - $ (�©'Q d `J Lot No. 2 Site Plan Name: �� l�� Block No. Z�1 Project Name: Setbacks Front �� Back: - - Right Side:"8— Left Side: — DETAILED-DESCRIPTION 01 "WORK CONSTRUCTION INFORMATION: Additional workto" e performed� under-this-permit-check all appy: HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors Electric ❑_Plumbing Sprinklers 0 Generator F] Roof Total Sq. Ft of Construction: ._ S . Ft.of First.Floor: Cost of Construction:$ "�� Utilities: _Sewer®Septic Building Height: OWN ER/LESSEE:;," CONTRACTOR: Name �� �Q(� (i�l�T '� Name: Robert Koenekamp Address: ��©aJ� c9E'_�yE Company: East Ocean Electric of Florida, INC City: ?A P Stater Address: 3550 NW 8th Avenue, Unit 305 Zip Coder 10(`�A__ Fax: 1� City: Pompano Beach State:FL Phone No. �-I () -0 :�Io k 14 Zip Code: 33064-3008 Fax: 561-228-8374 E-Mail: 'J AN 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. t• SUPPLEMENTAL-CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phon FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: I I Name: Address: U Address: It I City: City: Zip: Phon : 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 thepermit 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 wor or recording o Notice of Commencement. Q s _Si nature of Owner/Lessee/Agent Signatu a of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY O F PALM BEACH COUNTY O F PALM BEACH The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this JL day of 20 lb by this /t day 20 by ROBERT KOENEKi MP ROBERT KOENEKAMP (Name of person acknowledging) (Name of person acknowledging) (Signature Notary Public-State of Florida) (Signatur of No ry Public-State of Flon a ) Personally Known OR Prod' e dentificatiof�— Personally Known OR Produce 9ntification Type of Identification Produced Type of Identification Produced ( Commission No. „�����,,, (Se4RIS A.FLORES ommission No. 3 4S' 04h UA�i f Notary Public-State of Florida INGRIS.A.FLORES 9 7 = Notary Public Statpnf pi - �N - ° Commission#FF 039856 p°P My Comm.Expires Sep 12,2017 ;, ',9lFl°jljj\ ` '��;,,,�„„ Commission#FF Revised 07/15/2014 "'� °FFA° � 039856 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS