HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5-3-16 Permit Number:
J,_ _
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
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential x
Legal Description: LAKEWOOD PARK -UNIT 12-A-BLK 173-A LOT 4 (MAP 13/13N) (OR 3939-8720)
Property Tax ID #: 1301-615-0128-000-8
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No. 4
Block No. 173-A
Install new 200 amp panels and breakers. Replace 2 gang meter can and overhead service.
1-1 HVAC ❑ Gas Tank
✓Electric ElPlumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 2-
— cnecK a
Sas Piping U Shutters o Windows/Doors
Sprinklers 0 Generator ❑ Roof
S Ft. of First Floor: _
Utilities: Sewer E]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Harmony Management Solutions, LLC
Name: Tim Guy
Address: 5106 LaSalle St.
Company: Guyco Electric, Inc.
City: Fort Pierce State: Fl
Zip Code: 34951 Fax:
Phone No. `1 12- 532- 200
Address: 118 Friar Ct.
City: Sebastian State: A
Zip Code: 32958 Fax: 772-581-8383
Phone No. 772-388-0667
E -Mail: KoRPce, S:2:7 t QMcx czm
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: tim@guycoelectric.com
State or County License: EC13002990
IT value of construction is .5Z500 or more, a RECORDED Notice of Commencement is required.
ENTAL CONSTRUCTION
I Name: — ^Hwr°sure
Address:
City;
Zip: State:
Phone; --
FEE SIMPLE TITLE HOLOER: ,Not Applicable
Name:
Address:
City; _
Zip:Phone:
• ,vrv,
MORTGAGE COMPANY:
Name: Not Applicable
Address:
City; State:
Zip: Phone;
nONDINGCOMPANY;
Name: 9NotApplicable
Address:
zip; Phone:
I certify that no work or installation has commenced Prior to the Issuance of a permit,
St. Lurie County makes no representation that Is granting a permit will autporize the armit holde to build the ubJect s ructure
which is in conflict with any applicable Home O i ap t
structure. Please consult with your Home Owners Assoc ationtand review your deed lot covenants
thatnmsay eh ansa r pro hibit such
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work apply.
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
: Your failure to
improvements nu�o youRpro perty. No Notice of Commencem nttmust be recoencement rded aid posted on ttwicehe Johsite
before the first inspection. if you intend to obtain financing, consult with le er or an attorney before
commencingwork or recording our Notice of Commencement.
Signature of Owner/ lessee/Agent Signature of Contra for License Holder S
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L t COUNTY OF i i,- Z) t
The forgoing instrument was acknowledged before me
this d dsy of _ mrT_ 2 H?�' by,
Personally Known ✓ OR Produced Identification
Ty a of Ide till pod
The for oing Instrut�ent was acknowledge before me
this, day of V`{ '-� ZC (t_ by
(Name of person acknowledging) _
(Signature of Notary Public- State of Florida )
Personally Known ------OR Produced Identification
p n cation r used Type of Identification Produced
Commission No. mission No. ..°1111"•,.,
,�„ TE �LAIA
,.y ER REBECCA KiMME ; 1st Notary Publlc •Slate of Florida
ase Notary Public • State at FI a Commission N FF 1143
. • omm q on ♦ FF 183708
Revised 07/15/2014 , ,,,t.?; F MY Comm. Expires Dec Is, 2ete r •' My Comm. Expires Jun 29, 2019
fMMed lNprpa ttatiptai Nagynam. a
Nallonatmotarymm.
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