HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,�`a �� Permit Number:
RECEIVED OCT 2 8 2016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553' Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: `/:Z155& Riverbend Trace#CATV, Port St Lucie 34984
Legal Description: Bay St Lucie Tract E (0.65AC) (Map 44/22N) (or 875-8322:879-1510)
Property Tax ID#: 4422-502-0004-000-7 Lot No.
Site Plan Name: Block No. _
Project Name: Comcast Power Suppy P11
Setbacks Front Back: Right Side: Left Side:
FDETAILED DESCRIPTION OF WORK:
Install new Comcast power supply cabinet next to damaged cabinet located approximately 43 ft west
of Riverbend Trace, 102 ft north of Riverbend Rd. Remove damaged cabinet when new is energized
CONSTRUCTION INFORMATION:
Additional work o fi
orme un er is permit—c ec a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
ZElectric El Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 8.5 Sq. Ft.of First Floor:
Cost of Construction: $ 722 _ Utilities: Sewer®Septic Building Height:
OWNER/LESSEE:: _ CONTRACTOR:,.;,. .
Name Anthony Springsteel, Const"
uctin.:Manager Comcast Name: Gary J;Gifford
Address:3960 RCA Blvd,:Suite"6002 Company: Gary""J;Gifford;:Lnc.
City. Palm Beach Gardens r„ ,` 5tate:FL Address: 350 SW-Linden St
Zip Code: 34110 Fax:561-45458;99: City: Stuart State:FL
Phone No.561-804-0973 Zip Code: 34997Faz:,772=219-0146
E-Mail:anthony_springsteel@cable.comcast.com Phone No. 772-286-0954 _
Fill in fee simple Title Holder on next page(if different E-Mail: giffelec@comcast.net _
from the Owner listed above) State or County License: EC13001574
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL.CONSTR.UCTfON LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x 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: x 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
com4ncing work orrecordiniz vour Mficeof Commencement.
s
nature of 0 r/L see Contr for as Agent for Owner Signat400n"tra or Lice H er
STATE OF FLORIDA - STATE OF FLOR A
COUNTYOF_ COUNTY OF
The_f`Toing instrument was acknowledged�F efore me The forgoing instrument was acknowledged before me
this_day of C'SC�� 20 Eby this_day of OC:* 20 V6 by
(Name of person acknowledging) (Name of p son acknowledging)
(Signature of Notary Publ!bJState of Florida) (Signature of Notary Public State of Florida)
Personally Known_ OR Pro uced I n Personally Known OR Pro tifica n
Type of Identification Produced �E� 2202 Type of Identification Pro 's 1
"'\0't%
Commission No. M�� ��e ^��s Commissi �5 9510 mfQ2c2�Qy�t` w
tib. �;:: �' tts�N°� •<: ��N�
O: •). C••
Revised 07/15/2\ 1.6
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS