HomeMy WebLinkAboutBuilding Permit Application Oct 131612:12p Jimmy Rowell Electric 772-220-2755 p.2
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10-13-2016 Perm it.Nu m ber: 11D
Building Permit Application
Planning and Development Services OCT 13 2016
Building and Code Regulation Division PERNUTTING
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residenjiaf�Pounly, FL
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT-113CATION:
Address: 9564 Avenel Ln,Port Saint Lucie, F134986
Legal Description: The Pines at The Reserve
Property Tax ID#: 3322-502-OD33-000-9 Lot No.27
Site Plan Name: Block No.
Project Name: Christine Polo
Setbacks Front Back: Right Side: Left Side:
DETAILED,DESCRIPTION OF WORK:
Wiring of Electric Shutter See SLC Permit #1609-0207
[CONSTRUCTION INFORMATION:
Additional worktobenerformed under this permit—check all that apply:
HVAC Gas Tank ❑Gas PipingShutters Windows/Doors
ZElectric Plumbing FSprinklers OGenerator Roof Roof pitch
Total Sq.Ft of Construction: Scl.Ft, of First Floor:
Cost of Construction: Utilities: Sewer Fiseptic Building Height:
OWNER/i ESSEE: .-.CONTRACTOR..'
Name Christine Polo Name: James M Rowell
Address:9554 Avenel Lane Company: Jimmy Rowell Electric
City: Port Saint Lucie State:F,1 Address: 826 SE Dixie Highway
Zip Code: 34966 Fax. City: Stuart State:Fl
Phone No.772-882-4122 Zip Code: 34994 Fax: 772-220-2755
E-Mail: Phone No. 772-220-8850
Fill in fee simple Title Holder on next page I if different E-Mail: JRowel]Electric@aol.com
from the Owner listed above) State or County License: EC 13002740
If value of construction Is$2500 or more,a RECORDED Notice of commencement is required.
Oct 131612;13p Jimmy Rowell Electric 772-220-2755 p 3
SUPPLEMENTAL(ONSTRUCTIOP; UEN.LAWINFORMATION:.
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 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
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
copi?Wcing work or recording our Notice of Commencement.
i ature of Owner/Lessee/Contractor as Agent for Owner !)Inature of Contractor/License Holder
tr
STATE OF FLORIDJt,��� STATE OF FLORIDA
COUNTY OF y'�' COUNTY OF Martin
The forgoing instrumieqt w@s acknowledged before me The forgoing instrument was acknowledged before me
this.,jam,day of 1QC _ 20 Eby this 'a,n day of acture' 20 v by
{Name of person acknowledging) (Name of person acknowledging)
tpiaiure of Notary Publi -State of Florida) ISI n tore of Giary Pu-blfStakeof Florida)
Personally Known OR Produced Identification Personally Known - OR Produced Identification
Type of identification Produced Type of identification Produced
Commission No.a(:.45 a`24!�� (Seal) Commission No.QG OC3 4= =fly(Seal)
0 JULIE MARIE:SUNGY
Revised 07/15/2014 My COMMISSION#GG009415
"PIMS July K 2020 My COMMISSION#GG009415
jufy eel 201
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