HomeMy WebLinkAbout1605-0284SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER' Not Applicable I MORTGAGE COMPANY.
Name: --
Address:
City: State
Zip_ 'hone:
Not Applicable
Name: _
Address_ _
City: State:
Zip- Phone:
FEE .SIMPLE TITLE HULM: Not Applicable I BONDING COMPANY: Not Applicable
Marne:
Address,
City:
Zip: Phone:
Name.
Address_
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St_ Lucie County snakes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Horne 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 fallowing 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 resatt in your paying twice for
improvements to your {property. A Notice of Commencement roust 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 your Notice of Commencement_
_ Signature of Owned Ees�seefAgent Signature of Contractor/License ,Molder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Cf]UNTYOFA+mn
The forgoing instrument was acknowledged before me � The forgoing instrument was acknowledged before me
this day of 201 LlEby this 73h dayof nn , 20 g_ by
Kotary Public -State of Florida )
Personally Knovwn2!2__ CSR Produced Identification
Type of Identification Produced
Commission No, fir(Sear
Revised 07/15/2014
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(N mc* csf person acknowledging j
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(Sig to e f Notary Public- State of Ilorida
Personally Known Xxxxx OR Produced identification
Type of Identification Produced
Commission No_
ICY CWMIS&DN i fFJAW2
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
BATE
CR=1M PLE.IE
INITIALS.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: May 13, 2016 Permit Number:
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: 7805 San Carlos Drive, Lakewood Park, Florida 34951
Legal Description: LAKEWOOD PARK-UNIT 3-BLK 18 LOT23(MAP 13/14N) (OR 1231-2957)
I
Property Tax ID#: 1301-603-0053-000-4 Lot No.23
Site Plan Name: Block No. 18
Project Name: MAPLE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Convert from over head to underground electric
i,
CONSTRUCTION INFORMATION:
Additional work to be nerformed under t ispermit–check all appy:
HVAC _Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric E] PlumbingSprinklers F Generator E Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
i
Cost of Construction:$ CD . Utilities: —Sewer Septic ;Building Height:
OWNER/LESSEE: CONTRACTOR
Name Robert&Debra Maple Name: Donald B Green
Address:7805 San Carlos Drive Company: Don Green Electric
City: Lakewood Park State:FIL Address: 1305 W 1st Street
Zip Code: 34951 Fax: City: Fort PierceState:FL
Phone No. Zip Code: 34982 Fax:
E-Mail: Phone No. 772-418-5739
Fill in fee simple Title Holder on next page(if different E-Mail: dongreenelectric@gmail.com
from the Owner listed above) State or County License: E313007447
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.