HomeMy WebLinkAboutBuilding Permit Application 10/18/2016 1:59 PM FAX 7724663765 APPLEBEE ELECTRIC 0002/0005
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED }
Date.
fjD (� Permit Number: I 1n aM
ri �
Building Permit Application OCT 18 2016
Planning and Development Services PE lH IA I TTi NG
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 X Residential
PERMIT APPLICATION FOR: Electrical
:PRO POS.Em WR.'0V-g-m:ENT LOCATION':
Address: 121 N JENKINS RD
Legal Description. 12 35 39 THAT PART OF SE 114 OF SE 114.OF NE 1/4 MPDARBEG AT PT WILY RMI Ll OF JENKINS RD....
Property Tax ID#: 2312-144-0001-000-4 Lot No,
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
p:ETAILED D'ES RI.NTION'0F.,WOR.K:,
INSTALL CIRCUIT TO AUTOMATIC GATE OPENER.
.
` ai CONMION:. 'AT
--d-
Additionalwor to (epe orme unerthis permit—checka appy:
HVAC Gas Tank F]Gas Piping _Shutters ❑Windows/Doors
�✓ Electric ❑ Plumbing [:]Sprinklers Generator g Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 980.00 Utilities: Sewer I Septic Building Weight:
CT
Name CONSOILDATED PROPERTIES of FP Name: JOHN M.APPLEBEE
Address:5561 N- UNIVERSITY DR,#1103 Company: JAK, INC.,dba APPLEBEE ELECTRIC
Orty. CORAL SPRINGS 5tate:FL Address: P 0 BOX 15
Zip Code: 33067 Fax: City: FT.PIERCE State:FL
Phone No.(772)201-0647 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: EO#0002956
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
10/18/2016 1:59 PIf FAX 7724663765 APPLEBEE ELECTRIC 0003/0005
S ....PLEMENVIZONSTRUCTION LIEN.LAIN aNFORNfATION: „
DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
corrigWong work or recording our Notice of Commenceme
;gnature f Owner/Lessee/ g t Sign ure of antractar/License Ho r
T FLORIDA STACJ��
TY OF A . COUNTY OF
The forgoing instrume t.was acknowledged before me The fooing instrument was acknowledged before me
this� ay of 20 V6by thisL day of ZO 16 by
(N m of person acknowl ing) (Nam f person acknow ing)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
�rsonaII n R Prod d Identifi ation sonall n OR Produced identification
e-of Ide i c i T of Ide
98MM Or F005. 7 L lamb t1aE�ry Public State d FWW0
CommissioFF91f�49I) Commission + hL�ooFF847riaal)
a Exvirei 01125120M 'oi� Fx�ros Otr1S�Zo,Zo
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS