HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3_T�G Permit Number: \G43-6q % 0
�. RECEI`'rD MAR 312016
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
PROPOSED IMPROVEMENT LOCATION
Address: 2673 Lucie Lane Fort Pierce FL
Legal Description:
Property Tax ID#: 3405-802-0004-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
.DETAILED DESCRIPTION OFWMK:�:
emergency replace meter can due to broken lug. will need am inspection to repower if possible.
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—c ec a appy:
HVAC E]Gas Tank OGas Piping _Shutters Q Windows/Doors
ZElectric O Plumbing OSprinklers O Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
d Y
Cost of Construction:$ ./D PA Utilities. Sewer O Septic Building Height:
OWNER/LESSEE;: CONTRACTOR:
NameCharles Wyatt Name: Kenneth Waters
Address:2673 Lucy Lane Company: Waters Electric comp inc
City: Fort Pierce State:FL Address: 5500 Buchanan dr
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No. 11 a— 33 3-`ti 5 91 Zip Code: 34982 Fax:
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: Kenwaters@Live.com
from the Owner listed above) State or County License:2240-
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 theermit 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
commen ' work or recording our Notice of Commencement.
s
lgnature of Owner/Lessee/Agent Sign ure of Contractor/License Holder
STATE O LORI ,A STATE OF FLORID
COUNTY O COUNTY OF �1 ('��
The forgoing inst ment was acknowledged efore me The forgoing instrument was acknowledged before me
this',day of 20 by this day of Mia.fC.k 20 1U by
(Name of person acknowle i (Name of person acknowledging)
(Si ure o ota ublic-State oto ) (S" ure otary Public:-Sia of Florida)
Persona OR Produce Identification Personally Kno n V OR Produced Identification
y c pe of I frc'ation P
a � SH AW'1."°
Commiss' n No, �* ''" Comrtussion#2co"
commiss�i� 1+fi5549
MaY 1Commission No. - ; Expires M jl elf l
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Revised 07/15/2014
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