HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIV':-D JUN 0 m 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 Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED fIUIPROVEIVIENT LOCATI,QN
Address: 6011 BUCHANAN DR, FORT PIERCE, FL 34951
Legal Description: INDIAN RIVER ESTATES-UNIT-02-BLK 6 LOTS 64 AND 65(0.90 AC-39,600 SF)(MAP 34/11S)(OR 3747-784)
Property Tax ID#: 340260300390006 Lot No-6-
Site Plan Name: Block No. 64
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED.,DESCRIPTION OF WORK
�«
Install Temporary Power pole for Master Permit# 1602-0225. To be removed prior to final
inspection.
CONSTRUCTION I'NFORMATIO;N
�.
Additionalwork toe e orme under this permit—check a that appy:
HVAC 11 Gas Tank ❑Gas Piping I]Shutters ❑Windows/Doors
Z✓ Electric ElPlumbing ❑Sprinklers []Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 500.00 Utilities:Sewer 0 Septic Building Height:
OUVNER%LESSEE ` CONTRACTOR:
Name Brain Bean Name: John Cavnar
Address:1790 SW Bellevue Ave Company: Gold Star Security Systems
City: Port Saint Lucie state:FL Address: 10380 S.W.VILLAGE CENTER DR UNIT 152
Zip Code: 34953 Fax: City: Pt. Saint Lucie State:FL
Phone No. Zip Code: 34987 Fax:
E-Mail: Phone No. 772-380-5913
Fill in fee simple Title Holder on next page(if different E-Mail: jcavnar@bellsouth.net
from the Owner listed above) State or County License: 23575
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUf�PLEIVIENfiAL�CONS�RUCTION LI�N�LAW INFO�tMRTiON :F � �� ,������`,{ 3�y � ' 4 ��'�
DESIGNER/ENGINEER: _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 thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an 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
corrimpricing work or recording our Notice of Comm enceme t.
Aw
J4VS
ture f wner/Lessee Agent 79
ure of Contractor/License Holder
TATE OF FLORIDA STATE OF FLORI q
COUNTY OF -6 COUNTY OF r• Lu tv
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of �%,y-
20 NG by this_3W day of�TuyyL 120 jf_by
(Name of person acknowledging) (Name of Oelson acknowledgin
a
(Signature of Notary Pubic-State of Florida) (Sign atur o ic-State of Florida)
Personally Known OR Prod
fi��NS a Personally Known OR Produced Identification
Type of Identification L .c-State �
Oro Type of Identification Produced PL ICUP'<S kp &k
No�yY PUg N0 a mm.ExPltes 858781 JORGE LUIS NAVARRO.JR.
Commission No. Sion#EE N wl Assn•'commission No. NgTdgyPUBLIC
'4 Bonded th�ou9h Nat�onat STATE OF FLOFJDA
'E OFFmg FF149298
E Expires 8N0/2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS