HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-` G Permit Number:
G
RECEIVED JUN 2 7.616
Building Permit Application
Plarrtrg and Development Services !
Bulldliig and Code Regulation Division
2300Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial x Residential
PERnIItT'APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address:: 6795 S US HYW.1 i-
Lega[Description: model land co's s/d of sec 15 3640 blk 3 lot 2 in sw 1/4-less n 100f& lesss-s 179 ft of n 279
ft of 6:333 ft and less s 189 ft of a 333 ft and less rd r/w(5.50 ac) (or 1379-2569)
PropettyTax ID#: 3415-501-0039-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
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Setbeclrs Front Back: Right Side: Left Side:
Replacing burned up 120/240 volt 60 amp sub panel for sign at US 1
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Add
t ,.ona wor to Pop orme un er is perm —check a appy: i.
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HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
[]Electric 0 Plumbing []Sprinklers Generator Roof !=
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost:ofConstruction:$ 400.00 Utilities' Sewer r Septic Building Height:
Name 6759 Limited Name: Kenneth Geremia Jr.
Address: PO Box 24903 Company: 'GERELCO Electrical
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City: ':.`Ft Lauderdale State: FL Address: 560 NW Enterprise Drive
Zip Code: Fax: City: Port St Lucie State: FI. !:
Phone No. 772-461-5390 Zip Code: 34986 Fax: 772-340-7475 �.
E-Mail: Phone No. 772-340-7474 i
Fill in.hie simple Title Holder on next page(if different E-Mail: bwillard@gerelco.com
fro"e`Owner listed above) State or County License: EC/13003415
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 'al
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DESIGNER/ENGINEER: 1 Not Applicable MORTGAGE COMPANY: 1 Not Applicable _
Name;, Name:
Addre3s: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable -_
Name: Name'
Address: Address:
City:. City:
Zip: Phone: Zip: Phone:
cerft_Oat 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 j
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencingwork or rec2Eding your Notice of Commencement.
;6 A, 74 Z- S
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St. Lucie COUNTY OF St. Lucie
is
The'forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 29thday of June 20 16 by this 29th day of_ June 20 16 by
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(Name of person knowledging) —6y' (Name of person ac wled iter° TORI L 4Po'Al,l.ttlt
My COMMISSION#FF9093
YP -�•� )L WAiN�i� ,ovwa:�' EXPIRES October 11,201 i
9093 ature of Notary Public-
State o ori erv+ce.com
gnature of Notary Pu i" 'f EXPI ES October 11,2099
Personally Known ' rerl IrIFi�ANQ rvice.com rsonally Known OR Produced Identification
Type`,of ldentificatio_ Produced ype of Identiflc ion Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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