HomeMy WebLinkAboutBuilding Permit Application f
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5`L1 1% Permit Number: 1lr0G 5'OO�jq
' R E C E I D MAY 6 4.2035
� Y
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
PERMIT.APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATIONr ° s u ,+ ,*<<
.. 0 nr r„
Address: L F3 c) `""1 �!'sy c? Lr( 'P
Legal Description:
Property Tax ID#: �a�5- 40�- OO a- aoo - 5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
. - # r -.a•.. r+r { k.wa" "'?xt�`.�. �' is- "3,a .� -r r
DETAILED DESCRIPTION OFfiWORKR.
j �s. _' °'� % .
Baa
CONSTRUCTION£INFORIUTATI'ON � �� 4
AdditionalYmvi
workto e e orme under this permit'—check hall appy:
AC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
_Electric El Plumbing OSprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ ��� �' UtilitieslnSewer 0 Septic Building Height:
OWNER%LESSEE, 9w; � Ss �, CONTRACTOR
Name t; &&-aj '=`QCIt-
&;TI.,9 rl4e,`L- Name: EDWARD FLACK
Address: aebe -9c H 0 Company: KILOWATT ELECTRIC COMPANY
City: A& 6 Lem State: F Address: 1700#W 22ND AVE
Zip Code: �`/ `R,? Fax: City: POMPANO BEACH State:FL
Phone No. 9tiv I fL O — W 12- Zip Code: 33069 Fax: 954-975-9946
E-Mail: SAl' e a.3 .¢v r�+��" Phone No. 954-975-8200
Fill in fee simple Title Holder on next page(if different E-Mail: Eddie—flack@kilowatt-electric.com
from the Owner listed above) State or County'License: EC13001961
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SU,PPLEMfNTAL CONSTRIJCTIO,N LIEN LAW INFORMATION`
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: .1 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 fir pection. If you intend to obtain financing, cons with lend or an attorney before
commenciA,Wq,rKorrpn our Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signat&r6 of Contractor/License•Holder
STATE OF FLORIDA STATE OF FLORID hh
COUNTY OF ��iJO COUNTY OF �bLL1Q�pJl
The forgoing instryrrient was acknowledged before me The forgoing instrument was acknowledged before me
this _day of 20 >)�by this' day of 20 by
(Nam of person acknowledging) (Name of person acknowledgingOil
)
(Signa,Zot NotaryPu • -Staf of FI rida ) (Si n ure of Nota Pu Ic-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. "�►01"a'� RiBELC (yDRIGUEZ Commission No. g
o 'c MARIB L� ODRIGUEZ
�::
( MY COMMISSION#FF0984�5 =`•.. `= MY COMMISSION#FF098465
5,,,ori.•' PIRES iviarch 4,2018 '"' oFF;oQ,•= EXPIRES tviarch 4,2018
Revised 07/15 I 9MI5a FloridallotaryService.c.m :®1�5 FlarldallotaryServlce.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS