HomeMy WebLinkAboutBuilding Permit Application 10/10/2016 2:41 PM FAX 7724663765 APPLEBEE ELECTRIC 0002/0005
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/10/2016 Permit Number: l
LS.W AIR
1111 .
Building Permit Application
Planning and Development 5ervices
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.•I�IVLRROVEMENTi QCATIC)N:
Address: 1890 OLD FFA RD
Legal Description: AVON MANOR S/D-UNIT 1 -BLK B LOT 13(1454-345: 1632-2484: 3236-1696)
Property Tax ID#: 2303-610-0041-000-8 Lot No. 13
Site Plan Name: Block No. 8
Project Name:
Setbacks Front Back: Right Side: Left Side:
[EETATILD-D'ESIG''111'PTI.ON• OF•WORK:.
SERVICE REPAIR DUE TO STORM DAMAGE
so(1rI C¢
CONSTRUCTION.•I N FO R MATI O•N
Additional work o +e nertormed under this perm[t—cneCK all apply:
HVAC Gas Tank Das Piping _Shutters I]Windows/Doors
Electric LJ Plumbing OSprinklers F Generator F Roof
Total Sq. Ft of Construction_ Sq. Ft.of First Floor:
Cost of Construction:$ 900.00 Utilities: Sewer[:]Septic Building Height:
:-OWNER[ ESSE:E. -. ,.;::. • :C0.111.TRACTOR: .
•.; .
Name KERRY G AM05 Name: JOHN M.APPLEBEE
Address:1890 NORTH OLD FFA RD Company: JAK, INC.,dba APPLEBEE ELECTRIC
City: FT. PIERCE State.FL Address: P O BOX 15
Zip Code: 34945 Fax: City: FT.FIERCE State:FL
Phone Na-(772)205-1567 Zip Code: 34954-0015 Fax: (772)466-3765
E-Mail: Phone No. (772)466-7930
Fill in fee simple Title Holder on next page(if different E-Mail: APPL.EBEEELECTRICCa BELLSOUTH_NET
from the Owner listed above) State or County License: EC#0002956
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
10/10/2016 2:41 PM FAX 7724663765 APPLEBEE ELECTRIC 0003/0005
SUPPLEMENTAL CONSTRUCTION LIEN-.LAW INFORMATION:-
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:
1 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 5t,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 tvuiice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the firg inspection. if you intend to obtain financing,consult with lender or an attorney before
commen ' t or recwding your Notice of Comm enc ent.
s
5' nature of 0ner/ a/Agent btua, of Contractor i en a older
STATE OF FLOR( A TE OF FLORIDA
COUNTY OF a--w COUNTY OF
The forgoing[instrurnerit was acknowledge before me The forgoing instrument was acknowledged before me
this=day of - 20`IL by this_day of 20 by
(Name ofs n acknowledg g) (Name of person acknowledging)
(Signature of NotaryPublic-State of Florida) (Signature of Notary Public-State of Florida)
,,Personally Know p Personally Known OR Produced Identification
_
Tde ficatio P-4d Type of Identification Produced
Commission No. MYC==
=947M Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS