HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Xzl—alj Permit Number:
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Building Permit Application JAN 12 2017
Planning and Development Services
PERMITTING
Building and Code Regulation Division
St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X — Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: x.53 ;Z&fAv
a / SL 3� 5�
Legal Description: dLjg�y ��tiac,u
Property Tax ID#: Lot No. Z4AI
Site Plan Name: ''ll Block No.
Project Name: 6 9" _J_/QQ 1S
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit–check all that appy:
HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
ful
Electric Plumbing Sprinklers E Generator 1-1 Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ �o0- 0 C) Utilities:CnSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name C, Name. e
Address: 851, 9 aur. ,(S /�W�LoQ,w / Company:
City:PY- S1 LUOL'A State: Ii- Address:
Zip Code: 13 "VO-15A Fax: City:'7"6m 'Ap"A_Ci State:
Phone No. Zip Code:0`-195C5 Fax: Z
E-Mail: Phone No. !�&4/-a777 Z0 -Z., 9-'l
Fill in fee simple Title Holder on next page(if different E-Mail:_42,,_ E6 n��ePp�ieh�euL, Co M
from the Owner listed above) State or County License: 'C/3 00-.SBS 9
aSL e— 8 s
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
commencinR work or rpfQrding your Notice of Commencement.
s
Signa re of Owner/Les ee/Contractor as Agent for Owner Signature o ntractor/Licens older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_ LDitc.�a� COUNTY OF
The for c. g instru nt was acknowledged before me The forgoing instrument was acknowledged before me
this day of �! rlYltl� 20 Lby this�2`''day of , �wv 20 &by
I C� A,
(Name of person acknowledging) (Name oferson acknowledging)
P g g)
P"—
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known --'OR Produced Identification Personally Known !/ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. )�}0�¢7 S� r
NOD RA D TARY PUB 1(U PRl1Eommission No.
F�14'�1e7� I DAVID RAYmON RUE
NO
STATE OF FL IDA NOTARY PUBLI
Revised 07/15/2014 *E V" Expires 1/26/2019 Cc'rnrn#FF192675
Expires 1/26/201
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COM=INITIALS
L
I
PRIDt.
ELECTRI AL SERVICES OF FLORIDA, INC.
I ELECTRICAL RESER DIAGRAM
NOT TO SCALE
Use for Temporary Construction Power Pole and Single Family Service Change Only
RECEIVED
1
JAN 12 2017
PER�AITTING
St.Lucie County, FL
aM R"I
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1.Size Service: 11 WA
/> 2.Conductor Size: CU ❑ ALUM
P A 3.a.Meter Main: ❑
10r b.Meter Can Only:
M
1'
Gndi Electrode Conductor Size
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#6
❑ #4
❑ #2
❑ Oth r CONSTRUCTION TYPE:
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❑ Residential
Dual Electrodes or Test R ` uired
❑ Mobile Home
Digitally Pined ned b Michael Pride New Installation
DN:cn=Mchael Pride,o=Pride
Electrical n rvices of FL,Inc,ou, ❑ Old Installation
email=mi f @pride- electdcal.com,
847 SO H KINGS HIGHWAY, #TIM �• Afll-i%WFLORIDR 34945 • (772) 461-2777 • FRx (772) 461-2778