HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO I?►+1UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08J D2016
CcxL1 NT Y
F C n k 1 v A'
Permit Number:
Building Permit Application
Planning and Development Services
Furlding and Code Reguiotion Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone. (772) 462-I553 Fax- (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVE FNT LOCATION:
Addrris : 2404 BLOSSOM CT
Legal Description: ORANGE BLOSSOM ESTATES -2ND ADDN-2ND FLAT eLK 5 LOT 7 (0.19 ACF) (OR 3838-2717)
Property Tax ID #; 2421-609-0008-000-4 Lot No. 7
Site Plan Name: Block No.
Project Marne: 8LOSSOM OT
Setbacks Front
Back: Right Side; Left Side:
DEFrAILED DESCRIPTION OF WORK. I
Remove existing 100 amp meter can and 150 amp panel and install all new service including riser to
conform to current electrical cedes.
CONSTRUCTION INFORMATION:
Additional work to rformed under t ispermit - -,c
11HV'AC Gas Tank ❑Gas Piping
€Iectric Plumbing O5prinklers
Total Sq. Ft of Construction,
Cast of Construction: 1200
injappiy+:
Shutters
QGenerator
SFt. of First Floor: _
Utilities:115ewer E Septic
OWNER/LESSEE:
Nam David Freely
Address: 2404 BLOSSOM CT
CityFort Pierce State: FL
�
Zip Code: 34952 Fax:
Phone No. (772) 801-5548
E -Mail;
Fill in fee sirrnple Title 'Llnlder on next Page ( if different
from the Owner listed above)
CONTRACTOR:
Name. Donaki B Green
Windows/Doors
Roof
Building Height:
Company_ Dora Green Elec�triC
Address: 1305 W 1st Street
City: Fart Pierce State: FL
lip Code: 3490.2 Fax,
Phone Ijo_ 772-418-5739
E -Mail: dongreenelectric@gmail.com
{ State or County License: EO13007447
If value of construction is $2500 or mwq, a RECORDED Notite of Cornmencernent is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: K Not Applicable MORTGAGE COMPANY. x Not Applicable
Name: Name
Address: Address::
City: Mate: City: State:
Zip_ Phone- _ Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Narne:
Addre-ss_ Address-
City, City=
Zip: Phoma: Zip; Phone:
I certify that no work or installation has commencer 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 subiect structure
which is in conflict with any applicable Home € wners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consent with your Hoagie Owners Association and review your deer) for any restrictions which may apply_
Irl 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 Buiidinq Codes and St. Lucie County Amendments.
The following building permit appiication5 are exempt from undergoing a full concurrency review: room additions,
accessary structures, swimming {pools, fnncasr walls, signs, screen rooms and accessr}ry 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
cor=encing work or recording your Notice of Commencement.
Signature oforitraCtor/License Hct r
Signature of C]wvnr/ LesseejA�a,t
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA j
COUNTY OF
The forgoing instrument wa, acknowledged before rrne
I day P C'-0 20
The forgoing instrument was acknowledged before me
khis TZ43y by
this of 0 y
of ---P 120 I._L
;Na.tPersa�lly
14f ersean acknowledging)
ot4�ulc-tateof Fel a)
(Signa ie ca Votary Put iic Slate of Flari j
Personally Know OR Produced Identification
Knouvr� OR€'rudueecf Ideratilicatiori .. .
Types of 1dr:ntification Produce
Type of ldenti#i',caticrra produced
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Commission No. � � �d' IhdISSlt1N �FF94 2
RS IRES; JM 135, 2021
Commission Na: �t�� �°}�� J� KSTiNE OOPELMID
1w91�$9CJN #fF946G+12
9ondee through 1s sloe Ire e ncs
EXPIRES: JAN 05. x020
Revised 0711. 5/2 014
REVIEWS FRONT ZONING SUPER'Vi40R PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER RF-VIFW REVIEW RFVIFW REVIEW REVIEW REVIEW
DATE
CIM PLETE
INITIALS