HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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
PERMIT APPLICATION FOR: Electrical
.PROPOSED IMPROVEMENT LOCATION:
Address: 1199 COUNTRY GARDEN LANE
Legal Description: WHITE CITY SEC(TOWNIRANGE 09136SI40E
Property Tax ID#: 3403-502-0232.-040A Lot No.
Site Plan Name: Block No,
Project Name: SULLIVAN RES
Setbacks Front-- Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
SERVICE CHANGE TO REPLACE THE 150AMP MAIN BREAKER PANEL WITH NEW 150AMP
MAIN BREAKER PANEL. INCLUDES NEW CIRCUIT BREAKERS
[CONSTRLI&ION INFORMATION:
'Addit-16in-alw—or�Yt-o-15e--rD)-e-ffo-r-m-e-ff--u-nUe-r-Tis 7p-eit-iii-t check a7t apply-
0 HVAC Gas Tank F]Gas Piping _Shutters Windows/Doors
F]OElectric Plumbing F]Sprinklers Gerierator Roof
Total Sq. Ft of Construction: SFt of First Floor:
Cost of Construction: $ goo Utilities:n Sewer F]
Septic Building Height'.
OWNERAESSEE:
CONTRACTOR:
Name KATHLEEN SULLIVAN Name: CHARLES HOPPMANN
Address: 1199 COUNTRY GARDEN LANE Company: BELLWETHER ELECTRIC CO
City: FORT PIERCE State:FL Address: 571 NW MERCANTILE PL #103
Zip Code: 34982 Fax: City: PORT ST LUCIE State:FL
Phone No. 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,ELECTRIC@GMAIL-COM
from the Owner fisted above) State or County License: EC13004122
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLE- ej4T�AL,aCONS_TRVCTilON.L{.EN.i',-'. ,-INS RMATION:
DESIGNER ENGINEER: i Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: r„-,-Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address. Address:
City: City:
Zip: Phone: Zip: Phone
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County make$no representation that is granting apermit will authorize the permit holder to build the subject structure
which is in conflict with any ppiicable dome Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult witt 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
be"re first inspection.If you intend to obtain financing,co I with lender or an attorney before
coin work or recording our Notice of Gommenceme .
l
Sign re of owner/Ag-entl Lessee Signature Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF sytum COUNTY OF g*LurA
The fgrgoing inst t w�knowledgedjbefore me The forgoing instru en s acknowledged before me
this day of 20 by this, day of 20_4 by
(Name erson acknowled ) (Name of person acknowledgin )
( ature of Notary lic-State of Florida) (Signature of Notaryublilic-State of Florida}
Personally Known__,V OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced Type of identification Produced
Commission No. f Commission No._fE8S943i
-fir. CHRI E CRAVEIRO �,a�•. - C RIS INE CRAVEIR
My COMMISSION B EE850431MUMI
'neo, EXPIRES December 19,2016 'i;� r Ft,,.� EXPIRES December 19.201
Revised 07/151202
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS