HomeMy WebLinkAboutBuilding Permit Application 'ALL APPLIC BLE I JFO MUST.BE COMPLETED FOR APPLICATION TO BE ACCEPTED I I
Date: , Permit Number:
_e 166
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 xxxxx. Residential
PERMIT APPLICATION FOR: Electrical
PAOPOSED;IMPROVEMENT LOCATION:
Address: 3501'Orange Ave, Fort Pierce FL
Legal Description: 8 35 40 E 200 FT OF N 225 FT OF NW 1/4 OF NE 1/4 OF SW 1/4-LESS N 40 FT AND LESS AS IN ORD TAKING CA#82-59-05-(0.80 AC)(OR 2312-195)
Property Tax ID#: 2408-312-0001-000-3 Lot No.
Site Plan Name: 3501 Orange Block No.
Project Name: HELPER
Setbacks Front Back: Right Side: Left Side:
DETAILED-,DESCRIPTION "OF-WORK:
Building was vacant and was vandalized.and copper wiring was removed
CONSTRUCTION INFORMATION:
Additional work to be r)erformed under tis permit—cleck all appy:
HVAC LI Gas Tank alias Piping _Shutters a Windows/Doors
Electric a Plumbing Sprinklers Generator 1:1Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ Utilities: _Sewer a Septic Building Height:
OWNERhESSE'E: CONTRACTOR:
Name D and M One LLC Name. Donald B Green
Address:100 Lakeshore DR Apt 1055 Company: DON GREEN ELECTRIC LLC
City North Palm Beach State:FL Address: 1305 W 1strStreet
Zip Code: 33408 Fax: City: Fort Pierce State:FL
Phone No.561-37677143 Zip Code: 34982 Fax:
E-Mail:helperdenni,s@yahoo.com Phone No. 772-418-5739
Fill in.fee simple Title Holder on next.page(if different E-Mail: dongreenelectric@gmail.com
from the Owner listed above) State or County License: EC130074.47
If value of construction is$2500 or more,a RECORDED Notice of Commencement is.required.
SUPPLEME"NTAL„CONSTRUC.Ti.ON LiEN LAW INFORMATION
DESIGNER/ENGINEER: x_Not"Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE MOLDER: X 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 toanother 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 t e^first inspection-. If.you intend to obtain financing, cons t with Lender or an attorney before-
col e4ficinwork or_rec' ording your Notice of Commencement.
SignatGre of Owner/Lessee/Contractor as.Agent for Owner Signature of Contractor/License Holder
STATE.OF FLORIDA t STATE OF FLORIDA
COUNTY OF 1` API-In T111 COUNTY OF
Th ptping instrument wasacknowledged before me The for oing instrument was acknowledged before me
thit day of \ 20 aby this day of - t20 F by
(N me of person acknowled ing.j (Nam- f person acknlwledging)
(Sign uref otary Public-State of lorida) (Signat of ary Public-State of Florida)
Personally Knowr�_OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
JOY CHRISTINE COPE
Commission No. o��Y=`;°o Commission No. o��� ` �l YC�(jR15SION#PELAND
_�' Stgl�140MMISSION#FF948042 {�j��l�d1MISSION#FF948042
EXPIRES:JAN 05,2020
r EXPIRES:JAN 05;2020
OF a Bonded thiough lst State lnsuran '
state insurance
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE (MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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