HomeMy WebLinkAboutBuilding Permit Application 01/16/2017 12:05PM FAX 7724663765 APPLEBEE ELECTRIC 0002/0005
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/112/2017 permit Number:
-. .;....................................-. ._. RECEIVrl JAN 1 7 f {?
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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 X Residential
PERMIT APPLICATION FOR; Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 14483 C24 CANAL RD
Legal Description: 19/20/29 36 39 THAT PART OF SEC MPQAF:FROM A PT ON SW RNV LI OF C-24 CANAL AS PER
DOT RNV MAP LAST REVISED 9-24-59 BEING A PT OF TANGENCY AS SHOW ON SHEET 8,TH N 46 56 00 E........
Property Tax ID#: 3319-100-0000-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETA(LEb.bE5CRIPTlON1 OF' 'WORk. ` • !c< .
INSTALLING 150 AMP SERVICE FOR 5HP SUBMERSIBLE PUMP.
CONSTRtJ�TfO;�I JWORMATIO.N:
itlon8 war k to a ei orme under is
_ perms —c ec all _appy:
LnHVAC GasTank ❑Gas Piping shutters ❑Windows/Doors
Z✓ Electric Plumbing ❑Sprinklers Generator Roof
Total Sq.Ft of Construction: Sq• Ft of First Floor:
Cost of Construction:$ 1,500.00 Utilities: Sewer a Septic Building Height:
:OWNER;(LESS.EE .
Name G&S KAMMERMAN LLC _ Name: JOHN M.APPLEBEE
Address:4641 TREE FERN OR Company: JAK, Inc.,d/b/a Applebee Electric
City: DELRAY BEACHState:FL Address: P. 0. Box 15
Zip Code: 33445-7065 Fax: City_ Ft Pierce State.FL
Phone No.(910)596-1708 Zip Code: 34954-0015 Fax: (772)466-3765
E-Mail: Phone No. (772)466-7930
Fill in fee simple Title Holder an next page(if different E-Mail: applebeeelectric@bellsouth_net
from the Owner listed above) State or County License: EC#0002956
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
01/16/2017 12:05PM FAX 7724663765 APPLEBEE ELECTRIC 0003/0005
SkJPPLEMENTAL 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 TITLEHOLDER: _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 Countyy 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 Codesand 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 our Notice of Commencement.
s
Si nature f Owner/Lessee ge Si ature o ontractor/Lice o r
COUNTY OF COUNTY
STA F FLORI '
COUNTY OF
The forgoing ins tru ent was acknowledged before me The forgoing instru ent was•acknowledged before me
this day of this 12' day of 20 JtJ_by
AL, Ja.1plo)-R�
(N I,
o person ackn ledging) (NaU of erson ackn ledging)
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(Signature of Notary P lic-State of Florida) (Signature of Notary Public-State of Florida)
P nally Know OR Produced Identification rsonally Kno P d I e t'fi a 1
is entifi do ,dad e
rualic Maw of MCI=
• Notary Public$tate o}}Fkd" • Trade L Lamb
Commission No. lLem!(Se11 Commission No T E Go rea Mission M6011114
My Commisst«t FF 947963
orr Explreso11Z5lZOZ0
fievised 07/15/2014
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