HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED,
Date: Permit Number:
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 X
PERMIT APPLICATION FOR: Electrical
El
",PROPOSED IMPROVEMENT LOCATION
Address: 1919 Wyoming Avenue, Fort Pierce, FL 34982 I,
L
Legal Description:
Property Tax ID#: 4�uCE) •daZQ' C)O.��a Lot No.
Site Plan Name: Block No.
I ,
Project,Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED,0ES-RIPTION.OF WORK � r+
CONSTRUCTION.INFORMATION
Additional work to be nerformed under this permit—check all appy:
- —
HVAC _Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric O Plumbing —]Sprinklers Generator ;Roof
Total Sq.,Ft of Construction: S . Ft.of First Floor:
b
Cost.oftonstruction:$ Utilities: _Sewer Septic Building Height:
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OWNER/LESSEE CONTRACTOR: .:: - I,
Name MARIA INFANTE Name: Robert Koenekamp
Address:1919 WYOMING AVENUE Company: East Ocean Electric of Florida, INC
City: FORT PIERCE State:FL Address: 3550 NW 8th Avenue, Unit#305
Zip Code: 34982 Fax: City: Pompano Beach Statf�:FL
Phone No. Zip Code: 33064 Fax: 561-378-6x81
E-Mail: Phone No. 561-502-9673 1
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.
I'
SUP-PLEMENTAL`CONSTRUCTION"LIENV 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
inaccordance 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 atto ey before
commencing work or recording our Notice of-Commenceme9V If
s
_Signature of Owner/Lessee/Agent Siture of Contractor/License Holder
STATE OF FLORIDA STATE OF-FLORT�I �al
COUNTY OF COUNTY OF � !G��1" '
_ oma
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before c o r
this day of 20 by this 17'h day of FEBRUARY 20by rn°U
fn V 'X p
1 ROBERT KOENEKAMP n
C9 vl
(Name of person acknowledging) (Name of person acknowledging) o 0
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(Signature of Notary Public-State of Florida) ( nat of Notary Public-State of Florida) LL
Personally Known OR Produced Identification Personally Known OR Produced Identific
Type of Identification Produced Type of Identification Produced DL
Commission No. (Seal) Commission No. (Seal)
Revised 0 /15/2014
REVIEWSFRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
j COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE ,
COMPLETE
INITIALS