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ALCAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
-1000o
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 2629 RAINBOW DRIVE FORT PIERCE FL 34981
Legal Description: SEC / TOWN / RANGE 05 / 36S / 05S
Property Tax ID #: 3405-414-0005-000-8
Lot No.
Site Plan Name: Block No.
Project Name: JACKSON SERVICE CHANGE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION' OF WORK:
MISCELLANEOUS WORK TO BRING HOUSE UP TO CODE INCLUDING A SERVICE CHANGE,
REPAIR SMOKE DETECTORS, REPAIR OR REPLACE OUTLET BOXES, LIGHTING, GFI'S &
DEVICES
CONSTRUCTION IN FORMATION:
AaMponal worK to i ert is Permit—c ec a appy:
onritorme
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Z(Electric
ElPlumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
,AJ
Cost of Construction: $ 2Tt� Utilities:Sewer Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name KENNETH&CHARLOTTE JACKSON
Name: CHARLES HOFFMANN
Address: 2301 OKEECHOBEE RD
Com an BELLWETHER ELECRIC COMPANY
Company:
Y
City: FORT PIERCE State:FL
Address: 571 NW MERCANTILE PL#103
Zip Code: 34950 Fax:
City: PORT ST LUCIE State: FL
Phone No. 172- ZDI - 9.ia4
Zip Code: 34986 Fax: 772 -621 -9164—
E -Mail:
Phone No. 772-621-9494
Fill in fee simple Title Holder on next page ( if different
E -Mail: BELLWETHER.ELECTRICOGMAIL.COM
from the Owner listed above)
State or County License: EC13004122
If value of construction 15 $2500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
DESIGNER/ENGINEER:
_Not Applicable
ZONING
REVIEW
MORTGAGE COMPANY:
_Not Applicable
Name:
SEATURTLE
REVIEW
MANGROVE
REVIEW
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.
Inconsideration 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 financingNconsult with lender or an attorney before
STATE OF FLORIDA
COUNTY OF STLUCIF
The f rgoing instr e t waas acknowledgedp efore me
this 1! of rtl 20 �2 by
CHPALESHOPPIWi
CHRISTINE CR
MY COMMISSION tl
STATE OF FLORIDA
COUNTY OF I..I.A
The forgoing instrument was acknowledged before me
this I dayof APRIL 20__4 by
HOPPMANN
9E1 acre of erson a owle i""- CHRISTINE C
IE85 91 (,� My COMMISSION
te. 20 uoi EXPIRES Decemt
Personally Known x OR Produced Identification _ I Personally Known _ / OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. EESSN31 (Seal)
Revised 07/15/2014
Commission No. EEse9a31 (Seal)
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS