HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'la�J�\Cfl Permit Number:
RECEIV'_7D JAN 2 5 2016
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: 7440 S OCEAN DR#826, JENSEN BEACH,FL 34957
Legal Description: SAND DOLLAR VILLAS CONDOMINIUM A-UNIT 826 AND UND PRO-RATA SHAREIN COMMON ELEMENTS(OR-3798-1324)
Property Tax ID#: 3522-602-0031-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
RE LOCATE EXISTING ELECTRICAL IN KITCHEN
Abd q 14. ��� I'� L-1 V 1 &0)-1:
rn p:5
[CONSTRUCTION INFORMATION:
Additional work to'be nerformed under this permit—check all thal appy:
HVAC Gas Tank �Gas.P.iping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total-Sq. Ft of-Construction: 1000 S . FtFt. of First.Floor:
Cost of Construction:$ 2000 Utilities: I� 1Sewer Septic Building Height:
OWNERAESSEE: CONT
Name VICTORIA VILLALBA ` a 'bNgT&O NsT ELEC7I3lC..
Address: C 'C'omp�ray. JOHN DU,NN
Citye,GC � Stata: 0
Zip Code: 3 V' '�� Fax: ? ' City: �`":° 1 Q ,•, :9, State:
Phone No. � " _ Zip Code: 3"S1 Fax:
E-Mail: Vic-ro2tA5 t/t(:I-okAAsSocrA7CS. UM Phone No. °112" ,3Z3 " 5X5"3
Fill in fee simple Title Holder on next page (if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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 work or recording our Notice of Commencement.
e 4. A�� s
_Signature of Owner/Lessee/Agent Signa o Contractor/License Holder
STATE OF FLORIDA ST E OF FLORIDA
COUNTY OF 1,I)IOMI L adc, COUNTY OF S-!. C4erli '
The for oing instr ment was acknowledged before me The forgoing instrument was acknowledged before me
this ( ay of nut 20 Lby this // day of 20 by
4411-110- /Y1• Garr I OS G
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary P blic-State of Florida) (Signature of Notary
,Public�State of Florida�"�,h
)
Personally Known I/ 0 P c I fi t' P rsonally Known `- OR Produced Identification
Type of Identification Pro ced,,4ra,r, Al INA u_BARRIOS T e of Identification Produced
�°= Notary Public.State of Flori a
Commission No. 0�o1391v =.• .._ ye@jMm.Expires Jun 9,20 EC mmiss[,n,.W,"j Mme[HFI 1F VITASCommission i FF 122396 ;:- Commission#FF 235193
k-1 EXIDIres 4.2019
Tlvu Troy Fain Im—806385.7019
Revised 07/15/2014
REVIEWS. FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS