HomeMy WebLinkAboutBuilding Permit Application 01/19/2016 11:38AM FAX 7724663765 APPLEBEE ELECTRIC l7J 0003/0005
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -7
Date: ( I�� �6 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2,300 Virginia Avenue,Fart Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial X Residential
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PERMIT APPLICATION FOR: Electrical
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Address: 5180 TURNPIKE FEEDER RD.
Legal Description: LAKEWOOD PARK-UNIT 12-A-BLK 171 LOTS 18,19 AND 20(MAP 13/12S)(OR 1756-1897)
Property Tax ID#: 1301-615-0079-000-9 Lot No_
Site Plan Name: Block No.
Project Name:
Setbacks Front _ Back: Right Side: Left Side:
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REPAIR ELECTRICAL SERVICE DUE TO TRUCK DAMAGE
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Additionalworktone e orme under this perms --c eca appy:
QHVAC E]Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑Plumbing U Sprinklers Generator Ll Roof
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2,480.00 Utilities: Sewer ElSeptic Building Height:
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Name LAKEWOOD PARK PLAZA LLC Name: John M.Applebee
Address:8963 STIRLING RD,STE 91 Company: JAK, Inc, d/b/a Applebee EIectric
City: COOPER CITY State:_ Address: FL
Zip Code: 33328 Fax: City: Ft. Pierce _ State:FL
Phone No.(954)990-9201 Zip Code: 34954-0015 Fax: (772)466-3765
E-Mail: Phone No. (772)466-7930
Fill in fee simple Title Holder on next page(if different E-Mail: applebeeelectric@bellsouth.net
from the Owner listed above) State or County License: EC#0002956
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
01/19/2016 11:39AM FAX 7724663765 APPLEBEE ELECTRIC 0004/0005
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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 ermit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Assoc ation 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 nonresidential 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 our Notice of Com mencement.
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_SVgnaturof Owner/Lessee A nt Sign ture o Contractor/Uc der
STFLORIDA STATE OF FLORIDA C— h
COUNTY OF COUNTY OF —.1�' • 464--.
The for5ping instr ment was acknowledged before me The forgoing instru ent was acknowledged before me
thls day of +� 20 Eby this 1 day of .2011. by
1 �
"5e of person nowledging) (Naof persona , owiedging)
(Sign Lure of NoRky Public-State of Florida) (Signature of Notary Public-State of Florida)
p a[ OR Produced Identification ersonall wn OR Produced Identification
o d ype of Identi t' P
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notary Public State of Florida ,► °� Notary Public State Flot o
Commissi . TracieLLamb (seal) Commission N Larpb °rfSfea�
y ommrssron EE 159114 My Cornmission EE 159114
os Expires 01/25/2016 rapt F,p Expims 01/25/2016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS