HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED {{��y t i
Date: ��V
l,Lanuary17,2017 Permit Number:
Building Permit Application'
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical
PROPOSED. IMP'PR MEW- T`LOCATIO'N,'
Address: 242 Silverstream Circle Lot 102
Legal Description: 33 34 40 S 650 FT OF NE 1/4 LYG W OF US 1-LESS TRACT TO'RUSSO-
ANDTHAT PART OF N 10 AC OF NW 1/4 OF SE 1/4 LYG W OF US 1 (25.12 AC)(Oft 1768-2079) ,
Property Tax ID tt: 1433-130-0004-000-1 Lot No.102
Site Plan Name: Ridgecrest Mobile Home Park Block No.
Project Name: Ridgecrest Mobile Home Park
Setbacks Front Back: Right Side: Left Side:
DETAI,LED;DESCRIPTIO:N OF'W0RK; :
Repair stove circuit. ;
CON'STRUCTION:INFOR;IN1"A ON -
Additional work to (eeoer orme un er this permit=checTaafr appy: ;I
1_1HVAC L_1 Gas Tank F]Gas Piping FI Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator F] Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 490.00 Utilities: Sewer a Septic Building Height:
-OW,N.ER/LESSEE CQNTRACTOR:.
Name Ridgecrest Mobile Home Park%Riverstone Communities Name: Jeffrey R.Waite
Address:300 E Maple Road Company: Infinity Electric,'Co. Inc
City: Birmingham State:M1 Address: 630 TalIPines Rd. ;
Zip Code: 48009 Fax: City: Haverhill j State: FI
Phone No.772-461-0459 Zip Code: 334151 Fax: 561-588-3805
E-Mail: Phone No. 561-662-9299
Fill in fee simple Title Holder on next page(if different E-Mail: InfinityEl6ctric@bellsoutfi_net
from the Owner listed above) State or County License::EC13005456
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If value of construction is 52500 or more,a RECORDED Notice of Commencement islrequired,
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S.UP:P-LEMENTA! CONSTRUCTION Lit -AW INFORMATION:
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: 1 Not Applicable
Name: Name.
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEESIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
f city:
City:
Zip: Phone: Zip: Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit. I
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 whI ch may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respect's,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 our Notice of Commencement.
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Sigq t r of caner/ essee/Contractor as Agent for Owner Si art' e o ontra o /License;Holder'
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STATE OF FLORIDA STATE OF FLORI
COUNTY OF CA, QafCV-N _ COUNTY OF 70,ky,
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this IA- day of� r��`-7 20 tam by this " day of �a•v�.r� ,20 �` by
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(Name of per acknowledging) (Name of person ackno a in
(Signature o Notary Public-State of Florida) (Signature of Notary) blit-State of Florida)
Personally Known OR Produced Identification Personally Known ! OR Produced Identification
Type of Identification Produced c— i,s c.. Type of Identification Produced
Commission No. �i ° 6v (Seal)
Commission No. gL18�1.50 (Seal) �
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Notary Public-State of Florida :'; +.j Notary'Publie-State of Florida
Revised 07/1.5/201
Comm
issioa#FF 948450 ='' ,;r Commission# FF 948450
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REVIEWS FRONT T'Z6i�tfi#GT� ` ' /ISR'-" PLANS Q7E'G ANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS