HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ('La"(_ 4
Permit Number: -
m � i
Building Permit Application
Plonningr and Development -Services
Building and Code Regulation Divrsivn
2300 Virginia .4 venue, Fart Puree rL 34982
i
Phone: (772) 462-%553 Fax: (772) 462-1578 Coerlmerbai Residential
PERMIT APPLICATION FOR: Electrical
p
PROPOSED IMPROVEMENT LOCATION:
Address: 8035 Plantation Lakes Dr. Fort Fierce FL
Legal Description: RESERVE PLANTATION -PHASE IIA- LOT 43 (MAP 33128N) (0R 3861-'1 W)
Property Tax ID ##: 3321-803-0047-000-1
Lot No, 43
Site Plan Mame:
Block No -
Project Mame: Plantation Lakes
—
Setbacks Front Back: Right Side:
Left Side:
[PETAILED DESCRIPTION OF WORK.
�C
`
)-
4
10
CONSTRUCTION INFORMATION:
Additional workr to a �€ ormn . under this permit - check
11HVAC D Elm Piping
O[napply�
Shutters L1 Windows/Doors
Gas Tank
LJElectric El Plumbing OSprinklers
[J Generator E Roof
Tectal Sq.. Ft of Construction:
S. Ft. of Fiat Floor: 2836
0Septic t Story
Cast of Construction: $ 14000 UtiIitiestSewer
Building Height:
-
O W N ERAESSE E:
CONTRACTOR:
Name Paga Investments LLC
Name: Oonald B Green
Address 129 Queen Christina GT
Company: Don Green Electric
City: Fort Pierce State: FL
Address_ 1305 W 1st Street
Zip Corse: 1 34948 Falx;
City: Fort Pierce 'State: FL
Phone No.
Zip Code: 34982 Fax:
E -Mail: _
Phone No_ 772-418-5739
Filt in fee simple Title Halder on next page (i€ different
E -Mail. 'dongreeneleetric gr'rail,com
from the Owner listed above)
State or County License: EC13007447
If value of construction is $25Oa or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER. x Not Applicable
Name,
Address: --
City: State:
zip: Phone:
FEE SIMPLE TITLE HOLDER. x Not Applicable
Name: _
,Address:
City:
Zip.
-phone:
MORTGAGE COMPANY- x Not Applicable
Natant:
` Aldress:
City: State: —
Zip: _ _- Phone,
BONDING COMPANY: x Not applicable
Name: _
Address,
City:
Zip:
I certify that no work or installation has carnrnenced Prior to the i�,5uante of a permit
Phone:
St- Lurie County makes no representation that is granting a permit will authorize the permit holder to build the _wbject structure
which is in conflict with any applicable HomeOwners Association ruler, bylaws or an co+renants that may restrict or prohibit such
structure_ Please consult with your Dame [Owners Association and review your deed for any, restrictions which may apply,
in consideration of the granting of this requested permit, I do hereby agrpe that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lurie County Arnendments-
The folImving buildini permit applications are exempt Irorn undergoing a full concurrency review: room .additions,
aeressary structures, swimming pools, fends, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice Qf Commencement may result in your paying twice for
improvements to your property- A Notice of Carnmencernent must be recorded and posted on the job5ite
before the first inspection- If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Corn mencement.
Signature of Gwner/ Lessee/Agent Signature of Comractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_ - �..tJ COUNTY OF
If �: Thefror ging i nstru mea t was acknowledged before me
thisday of 7.0 V- by
i�
{Marne of person acknowledging j
l ne�ing instrurn nt v++as acknowledged be are me
this day of , 20 I G,by
v '�.j
Personally Known _,K-- OR Produned Identification
Type of Identification Produced .
Commission No -
Revised 07/15/0
RE+JIENS FRONT
COUNTER
DATE
COMPLETE
INITIALS
Hili' COMMISSION 090042
EKpIRES: JAN 05. 202D
(Sign if o f Notary Public- State of Fla
PersonaIIy't�lown 0R Produred Identification
Type of identification Produced
Commission NO. (Seal)
my COUNIMSION igFF946042
EXPIRES: ,M 05.20M
Oaml®d OcUL4911 1 st SIVIO IrSLMce
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