HomeMy WebLinkAboutBuilding Permit Application 10/13/2016-1:35 PH FAX 7724663765 APPLEBEE ELECTRIC 0002/0005
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
10/10/201 s Permit Number:
/6/ 0.
Building Permit Application) OCT 13 201
Planning and Development5ervices
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
*PRO PdSW.'-1:M,PROVEMENT.�iACATION.
Address: 5106 CITRUS AVE
Legal Description: WHITE CITY BLK 42 LOTS 12 AND 13 ANDS 10FT VAC ALLEY ADJ ON N (0.285 AC)(OR 3269-307)
Property Tax ID#: 3404-501-0269-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED IE'SCRI:RTION��OF WQRK
REPLACE DAMAGED RISER FOR EXISTING ELECTRICAL SERVICE.
-'U' - 10
al work to ffGasTank
Orme un er rmis peit--c ec a appyHVAC Gas Pi in _Shutters Windows/Doors
ZElectric ❑Plumbing Sprinklers ❑Generator F—] Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 700.00 UtilitiesSewer Septic Building Height:
011V;�tEIfLESSEE:;.,,'.:'.,"'.:.::: ::. :::: ;,CONTRACTOR'::..:;.
Name MARK SCHNEIDER Name: JOHN M.APPLEBEE
Address;5106 CITRUS AVE Company: JAK, INC_,dba APPLEBEE ELECTRIC
City: FT.PIERCE State:FL Address: P O BOX 15
Zip Code: 34982 Fax: City. FT. PIERCE State:FL
Phone No.(772)216-5903 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. APPLEBEEELECTRICQBELLSOUTH.NET
from the Owner listed above) State or County License: EC 40002956
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
10/13/2016 2:19 PM FAX 7724663765 APPLEBEE ELECTRIC 0002/0002
-SUPPLEMENTALCONSTRUCTION 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:
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 thepermit 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 job-site
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
?ATEtuOF
re of Owner Les a gent Sign re of Contractor/ ceps H Ider
FLORIDA p STATE Or FLORID
COUNTY OF J7� • _ COUNTY OF . e,.
The for��,pping instrument was acknowledged before me The forgoing instrum,,,eq was acknowledged before me
this 1- day of 20 aby thiAV. CR
day of S20 ��.n by
(N e f person ackn ledging) {N of person ackn ledging)
(Signature of Nota ublic-State of Florida) (Signature of Notary Public-State of Florida)
)Aet]
ersonall OR Produced Identification P nally Know OR Produced Identification
T .e-o Identi yp
""N& ary rublic state or o Notary Public State of Florida
Trade L Lamb `. Trade L Lamb
Commission N �Cotamisg�onFd§ dk� Com No
47863 ( al)
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+v, Expires1/2512020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PIANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS