HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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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: 1406 N 37th ST
Legal Description: SUNLAND GARDENS BILK 27 LOT 12 AND N 10.2 FT OF LOT 13 (0.15 AC) (OR 3909-923)
Property Tax ID #: 2405-601-0499-000-8
Site Plan Name: 37th Street
Project Name: 371h Street
Setbacks Front Back:
Right Side: Left Side:
Re-energize permit - FPL is requesting before they install new meter
Lot No.
Block No.
CONSTRUCTION INFORMATION: j
Additional work toe befformed under this permit —check a appy:
HVAC Gas Tank []Gas Piping Shutters Windows/Doors
Electric D Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: -
Cost of Construction: $
Scl. Ft. of First Floor: _
Utilities: 0 Sewer []Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name R and D Management and Investments Inc
Name: Donald B Green
Address: 10380 SW Village Center DR # 333
Company: Don Green Electric
City: Port St Lucie State: FL
Zip Code: 34987 Fax:
Phone No. 772-528-0881
Address: 1305 VII 1 st Street
City: Fort Pierce State: FL
Zip Code.- 34982 Fax:
Phone No. 772-418-5739
E -Mail: vipconsults@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: dongreenelectric@gmail.com
State or County License- EC13007447
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
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 our Notice of Commencement.
ZL; �,,, —,. _ . $
signature of Owner/Lessee/Contractor as Agent for Owner I Signature of Contractor/ License Holder
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this `day of 20 }I by
Qonaid 6 Green
�,��t �� l• + l
(SigAatu a c Notary Public- State of 11orida )
Personally Known xxx OR Produced Identification
Type of Identification Produced
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this "'day of May 2057 , 20 i' % by
B Green ,
of pgrWp acknow dging )
of Notary Public- State of Flcti'da )
Personally Known xxx OR Produced Identification
Type of Identification Produced
Commission No.
�Oy�iINECOPELANO
Commission No. S0,C�COPELAN0
#FF948942
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11 gr.P!U MY COMMISSMN #FF948042
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MY COMMISSION
: SAN 05, 2020
Bonded through 1st State Insurance
aF Bonded through 1st State Insurance
Revised 07/15/2014
REVIEWS FRONT
ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS