HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \'1 `�c, Permit Number:
RECEIVED APR 0 7 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 xxxxxxxxxxx Residential
PERMIT APPLICATION FOR: Electrical
PRO.POSED IMP,.ROVEMENT-LOCATION:
Address 13400 GILSON RD , PALM CITY, FL 34990
Legal Description: Subdivision:4425701
Property Tax ID#: 442570100160004 Lot No.
Site Plan Name: Block No.
Project Name: Harbor Ridge Yacht and Country Club
Setbacks Front Back: Right Side: Left Side:
DETAILEp DESCRIPTION OF'WORK
Temporary Power ( rna S� t Q'�c+r,'r ' 1S 11 -au o y
CON STRiJCTION'lNFORMATION: =
Additionalwork to (e pe( orme under this permit—check a appy.
HVAC 1_!Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric F-1Plumbing Sprinklers 17 Generator E Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1000.00 Utilities:Sewer F Septic Building Height-
OWNER/LESSEE:' -,CONTRACTOR:
Name 1Ar, a
. �cat -fir., c-1 jj1 Name: KENNETH A GEREMIA,JR
Address: L`�- 600 61�A&= ���1 ux Company: GERELCO ELECTRICAL CONTRACTORS, INC
City: 1b l C, .c, State: t_L Address: 560 NW ENTERPRISE DRIVE
Zip Code:, r2 ctU Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34986 Fax: 772.340.7475
E-Mail: Phone No. 772.340.7474
Fill in fee simple Title Holder on next page(if different E-Mail: jleblanc@gerelco.com
from the Owner listed above) State or County License: EC13003415 I Q A(;Al
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGy�Jir,INEER: 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 first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 by this day of20 LIA-by
Smuffi A
(Name of person acknowledging) (Name of persona nowledging)
{Signature of Notary Public-State of Florida} ture of Notary Public-State of Florida}
Personally Known OR Produced Identification Personally Known) OR Produced Identification
Type of Identification Produced Type of Identification Produced
TO ARNER
Commission No. :;w. caw
Commission No. {Sea(} " + My COMMISSION#FFW9394
•alb' --EXPIRES OCUilier 11,2019
000398-0,53 FWftNow .c"
Revised 47/15/2014 b 11
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS �