HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST'BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 0-2 — QQ7-
RECEIVED
Building Permit Application
Planning and Development Services FEB m 3 2016
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 6143 South Federal Hwy
Legal Description:
Property Tax ID#: �/d = �'�� �� B�� Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�l1 S %a. �/ .� L�,ii �er e�rdw� d �an r� f/ulc �a r £/e•-TY•'c dunaTl'on�
CONSTRUCTIONINFORMATION:
Additional workto e e orme under t —checkispermit a appy:
HVAC Gas Tank ❑Gas PipingShutters a Windows/Doors
Z Electric F� CGenerator
Plumbing Sprinklers Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ � jy Utilities:11 Sewer Septic Building Height:
OWNER/LESSEE: - . CONTRACTOR:.
Name Benton Wood Moble Home Park Name: Lawrence Stubbs
Address:6143 south Fed Hwy Company: S&W Electric Inc
City: Ft.Pierce State:FL Address: 501 West Coker Road
Zip Code: Fax: City: Ft.Pierce State:FL
Phone No.954-478-7602 Zip Code: 34945 Fax: 464-4073
E-Mail: Phone No. 464-6466
Fill in fee simple Title Holder on next page(if different E-Mail; stuboutelectric@aol.com
from the Owner listed above) State or County License: 29442
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 the permit 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 ' st inspection. If you intend to obtain financing,cons- with lender or an attorney before
commeKirig work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent jXignaturie of Contractor/License Holder
STATE OF FLORI r 77hR
STATE OF FLORID Y�o
COUNTY OF COUNTY OF =_C'1
The forgoing instrum t was acknowledged befor rff The forgoing instru nt was acknowledge befor r �
this�_day of 20�(�by W w this day of 20��by ZE¢ e
Ca:z¢ C o pa
�01 � ¢UX m
(Name of person acknowledging) (Name of person acknowledging) J'
(Signature of 06tary Public-State of IYorida) (Signature of ary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS