HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
x Not Applicable
Address:
MANGROVE
Address:
COUNTER
City:
Zip: Phone:
State: _
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY:
Name:
x Not Applicable
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 contlict 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
b ore the first inspection. If you intend to obtain financi insult with lender or an attorney before
onnencine work or recordine vour Notice of Commen em A
as
STATE OF STATE OFRIDA
COUNTY OFO� , LIAC j E COUNTY OFORI LL&c 16
The forgoing instrument was acknowledged before me
this 10 day of A) OV. 20 Lby
(Name
The forgoing instrument was acknowledged before me
this 6 day of IVO/. 20 J-6 by
(Name of person
4% f— \
C�
A
(signature of Notary Public- tate of Florida ) Wgnature of NotK Kblliic- State of Florida )
Personally Known _ uced Identification Personally Known t/ OR Produced Identification
Type of Identification Pr Type of Identification Pr
MYc �ZI fNt DAVID JURKIEWICZ
Commission No. I�,,,ttµµSSION#FF Commission No. i• �1`
F ew/ 988909 '�: MY OCIAI 6610N # FF998909
bai ��75s FIRES June 05, 2020 EXPIRES June 05, 2020
FbM.un•..-...__ . _ r
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/10/2016 Permit Number:
s
r.
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: 16265 Carlton Adams Rd. Fort Pierce, FL 34945
Legal Description: LUKE'S LOTS (PB 41-4) LOT 8 (7.552 AC) (OR 3723-223)
Property Tax ID if: 2236-700-0008-00-6
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Install service for entrance gate and column lights, and hook up.
1:1
Lot No.
Block No.
1-1
CONSTRUCTION INFORMATION:
Additional work to b rformed under this permit— check all appy:
11 HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric Plumbing Sprinklers D Generator E]Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 2,275 Utilities:DSewer Septic Building Height:
OW N ERAESSEE:
CONTRACTOR:
NameJason R Baran
Name: Charles Hoppmann
Address: 16265 Carlton Adams Rd
Company: Bellwether Electric Company
City: Fort Pierce State:FL
Zip Code: 34945 Fax:
Phone No.
Address: 571 NW Mercantile PI
City: Port St. Lucie State: FL
Zip Code: 34985 Fax: (772) 621-9164
Phone No. (772) 621-9494
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: bellwether.electric@gmail.com
State or County License: EC13004122
IT value or construction is Szsuu or more, a RECORDED Notice of Commencement is required.
Karen Nielsen
From: . Philip Worley <pw.bellwether@gmail.com>
Sent: Tuesday, November 15, 2016 1:19 PM
To: Submittals
Cc: Charlie Hoppmann
Subject: RE:Your Permit Fees Are Ready For Payment for Permit# 1611-0218.
EN: Karen
applying under the master permit.
cel this pending application.
!
-----Original Message-----
From:Submittals@stlucieco.org [mailto:Submittals@stlucieco.org]
Sent: Monday, November 14,2016 8:23 AM
To: BELLWETHER.ELECTRIC@GMAIL.COM
Cc: couturierj@stlucieco.org;Submittals@stlucieco.org
Subject:Your Permit Fees Are Ready For Payment for Permit#1611-0218.
***DO NOT REPLY TO THIS MESSAGE***
Dear CHARLES HOPPMANN,
F
Permit es For ELECTRIC- RESIDENTIAL at 16265 CARLTON ADAMS RD FORT PIERCE FL 34945 are read
Youre y for
Payment.
Fee Amount Fee Description
$5.00 N-BP BIMS
$2.00 N-BP Surcharge-Permi701-Electric
Permit-(1&2 Family Residential)
$2.00 N-BP Trust Surcharge- Permi701-
Electrical Permit-(1&2 Fam Res)
$100.00 N-Permit Fee- Electrical Permit-(1&2
Family Residential)
TOTALBALANCE
--------------------
$109.00
1