HomeMy WebLinkAboutBuilding Permit Application 10/18/2016 1:57 PM FAX 7724663765 APPLEBEE ELECTRIC Q 0002/0005
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: IT I t o Permit Number:
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Building Permit Application' OCT 18 2016
Planning and Development Services PER Phi ITTI RI G
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Electrical
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Address: 280 LAMONT RD
Legal Description: 12 35 39 S 1/2 OF NW 1/4 OF NE 1/4-LESS W 47 FT FOR RD AND CANAL-AND 3 295.17 FT OF W
Property Tax ID#: 2312-123-0001-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
-D'ETAILEDrD'f=5CRIPTI`ON.O;F.WORK: . ..
REPAIR DAMAGED RISER AND METER CAN. 125 AMPS
CG'fTR'U:CTI.ON'�NFI?RMiATIO:N
Additional wor n Pa un er t is permit—check all tm appy:
❑HVAC Gas Tank OGas Piping _Shutters ❑Windows/Doors
Z✓ Electric 0 Plumbing ❑Sprinklers Generator ❑Roof
Total Sq. Ft of Construction: SFt-of First Floor:
Cost of Construction:$ 1,000.00 Utilities: ]" Sewer Septic Building Height:
(•WN ER' LESSEE, CONTRACTOR'' -
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Name SANFORD GIBSON Name: JOHN M.APPLEBEE
Address:280 LAMONT RD. Company: JAK, INC.,dba APPLEBEE ELECTRIC
City: FORT PIERCE State:FL Address: P O BOX 15
Zip Code: 34947 Fax: City: FT.PIERCE State:FL
Phone No.(772)216-5114 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: APPLEBEEELECTRIC@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.
10/18/2016 1:57 PM FAX 7724663765 APPLEBEE ELECTRIC [ ► 0003/0005
Sl7PglfMENTAL.CCIN.STftt1GTl• �1:lIEN CAW IN. (7RI�ATit}N:
Df=SIGNER/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 Nome 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 nonresidential 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
commencing work or recordin our Notice of Comm ncement.
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of Owner)LesseeJA en Si natu a of ontractorji a older E OF FLORIDA „
COUNTY OF COUNTY OF 5 �a n
The forgoing instrument was acknowledged before me The for�jping instrument was acknowledged before me
this day of � 20 by this�"gday of AL1+
26b by
(N of person ack ledging) (Na e f person ackn edging) /
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida}
ersonally K OR Produced Identification kisonally Know OR Produced Identification
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER. REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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INITIALS