HomeMy WebLinkAboutPERMIT APPLICATION ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r �!
Date: Permit Number: (010 0—
H
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: To Select from dropbox, click arrow at the end of line
-=PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID#: 3 30� 8�.3 - �QS�' d QQ - 9 Lot No.
Site Plan Name: ;> Block No.'
Project Name: D2a 1 /C
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�to2.iv I��c�rT�
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit-c ec a apply:
HVAC Gas Tank E]GasPiping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ �o DD. DO Utilities:ln Sewer 0 Septic Building Height:
OWNER/LESSEE: :CONTRACTOR:_.—_- -
Name Na~--- f - -
M
Address: (> S A) Ott. Co m p a r,
City: f- State: Add res RLL-J'
4GGLr _
Zip Code: 3499 G Fax: CityC'o
��^ 7�.Cs?�(�t� StatePhone No. Zip 7e3 48147 , Fax: —/(;/- -? 77 4
E-Mail: Phone Ni 46/-.A-777 -
Fill in fee simple Title Holder on next page(if different E-MF L%SL� (f P i b - Q t (- ' '
from the Owner listed above) State or County License: l_
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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:
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". Ifyou intend to obtain financing, consult with lender o an attorney before
commencing ork recording Your Notice of Commencement.
A/A I s
Sig t f caner/Less Contractor as Agent for Owner Signat of Contractor icense Holder
STATE OF FLO/R'-IZ�A STATE OF FLORIDA
COUNTY OF �_ (A,�{� COUNTY OFr
S�= �,�rte,Q,
The forging instru ent v�(as acknowledged before me The for ing instrument was acknowledged before me
this�day of !2r✓ 20 �by this May of 20 _&Z_by
c-( J' V'I Cc—
(Name
ame of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
PersUhZlly Known V'-OR-Produced lden'tification Personally-Known_ZGR Produced-Identification
Type of Identification Produced I Type of Identification Produced
&- -_Comni#FF192465 D PRUE 0—o-
DRQ WTMOON RUE
r o26-7SNOTARY PUBLICommission No. Fly � NOTARYPUBCommission No.STATE OF FLDA STATE OF FLOR A
Comm#FF19267
Expires 1/26/2019 xp res 0
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
PRIDE
ELECTRICAL SERVICES OF FLORIDA, INC.
ELECTRICAL RISER DIAGRAM
NOT TO SCALE
*Use for Temporary Construction Power Pole and Single Family Service Change Only
Marcellino Residence
i
8015 Plantation Lakes Dr
Underground
Overhead
1" PVC with 344 CU
I.Size Service: 1.00A.__.._
� Temp Panel
2.Conductor Size: Cu U ❑ ALUM
100A Main
Breaker Panel 3,a.Meter Main:
Single Phase
b.Meter Can Only: Ne
Panel Schadule
1.GFI 20a Z.Spare 20a
3.Space 4.Spare 20a
Total Amps:15A
M
"Co
1nduit twith 34 &
178 CU
Gro nding Electrode Conductor Size
7#6
❑ #4
❑ #2
❑ Other CONSTRUCTION TYPE:
❑ Residential
Dual Electrodes or Test Required ❑ Mobile Home
Digitally signed by Michael Pride ' New Installation
ON:cn=Michaet Pride,o--Pride
Electrical Services of FL.Inc,ou, ❑ Old Installation
00,
email=mike@pride-electricai.com,
c--Us
r
Date:2013.09.23 11:44:20-04'00'
847 SOUTH KINGS HIGHWAY, #104-B • FORT PIERCE, FLORIDA 34945 * (772) 461-2777 • FAx (772) 461-2778