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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 12-29-16 Permit Number: 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 X PERMIT APPLICATION FOR: Electrical PROPOSED IMPROVEMENT LOCATION: Address: 1293 Nettles BLVD Jensen Beach, FL 34957-3398 Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1293 AND PRO -RATA SHARE IN COMMON ELEMENTS (OR 3877-1248) Property Tax ID #: 4502-501-1480-000-6 Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Upgrade service with 200 amp meter/main Lot No. Block No. CONSTRUCTION INFORMATION: Additional work toe erformed under this permit — check all appy: HVAC Gas Tank Gas Piping In Shutters a Windows/Doors R1Electric � PlumbingSprinklers � Generator � Roof Roof pitch Total Sq. Ft of Construction: Sc, . Ft. of First Floor: Cost of Construction: $ 1100 Utilities: Sewer Septic Building Height: OWN ERAESSEE: CONTRACTOR: Name Belinda Rachwal Benjamin Rachwal William C Rachwal Name: Michael Flanagan Address, 1293 Nettles BLVD Company: First Quality Electrical Services City: Jensen BeachState: FL Address: 2336 SE Ocean BLVD #114 Zip Code: 34957-3398 Fax: City: Stuart State: FL Phone No. (772) 692-0124 Zip Code: 34996 Fax. E -Mail: WMRAC a@AOL.COM Phone No. (772) 263-8088 Fill in fee simple Title Holder on next page ( if different E -Mail: mflan@comcast.net from the Owner listed above) State or County License: EC13002096 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. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. s Si nature of Owner/L ssee/Contractor as Agent for Owner Signature of Contractor/Lice se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF L,,wr The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 2"b day of '�il�� 20 0 -by this day of "j flnn� . 20 by WILAaEJA &�U, tijP�L MICRPEL 'I Fb"WhCM (Name of person acknowledging) (Name of person acknowledging) w' f (Signature of Notary Public- State of FI da) (Signature of Notary Public- State of Firida"4 ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced �.•�•�Y PU+'•. C ELLE R GRA©Y ••••"Y LL t''`�•, RAC . GRADY Commission No. ;�q •fi'•: �r Commission No. .•' '': *• •�: MY` ��! 1SSION # FF 991041 MY COM # FF 991041 EXPIRES: July 21, 2020 �= EXPIRES: July 21, 2020 -c: •d$ Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS