HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�a Permit Number:
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Building Permit Application
Planning and Development Services Gi
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Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential.—
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line \�� G
PROPOSED IMPROVEMENT LOCATION':
Address: 10307 South Indian River drive
Legal Description: 3 homes on lot. Main house, 2 Guest homes in back
Property Tax ID#: 3�J a�.101-• 040 - d�0'3 Lot No.
Site Plan Name: Block No.
Project Name: Jessie Phillips home owner
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Change 100 amp service to a 200 amp service over head service for future swimming pool power.
Pool with heat pump. and hot tub. Add a 200 amp meter combo with built in 8 circuit panel and a 200
amp main breaker. Back feed existing 100 amp 20 circuit breaker panel with 100 amp breaker install in
meter combo outside.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit–check all that appy:
HVAC Gas Tank []Gas Piping Shutters ❑Windows/Doors
❑✓—Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 1200 sq ft. S Ft. of First Floor:
Cost of Construction: $ 2400.00 dollars Utilities: -Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name 5 SSS j F_ :n_Pk L�=T 'pSName: Robert T Payuk
Address: II/03C)7 -S, z4j4w <yVcc Company: Payuk Electric LLC
City: _�l Lu.c,"F LLwt( State: L Address: 2501 SE Calusa Ave.
Zip Code: Fax: City: Port Saint Lucie State: FI.
Phone No. qV_-307-11 Io1 Ej Zip Code: 34952 Fax: 772-335-1639
E-Mail: ticrl_ mm Phone No. 772-337-4197
Fill in fee simple Title Holder on next page ( if different E-Mail: bobtom12@bellsouth.net
from the Owner listed above) State or County License: EC13001275
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: N am e:Robert T Payuk
Address: 10307 South Indian River drive Address:
City: State: City: Port Saint Lucie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2501 SE calusa Ave. Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 propert . A Notice of Commencement must be recorded and posted on the jobsite
before the first i, ection. If ou intend to obtain financing, consul with lender or an a, ney before
commencing won or recoroffig your Notice of Commencement.
X��_/A
Signatur o ner/L ee/Contractor as Agent for Owner Signa a Con actor/ ' ense older
STATE O LORI A STATE OF FLORIDA
COUNTY OF is _ LV c COUNTY OF ,LJs VIZ,
The f9 rgoing instru ent was acknowledg before me The forgoing instrument was acknowledge before me
this (a day of 2011 by this day of P—c- 20 I� by
Lit� 1n c.T, k o b e r P A,y v K
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced �L L Produced rt t. L/
NAMA N#GG p22023
(Signature of Notary P is Sta N � tEGG 022023 (Signature of t: ,ti%-Sl tcUndenydter�
D t St�N t 16.2020 t„*: ThN Notary
Commission No. �+AYG � m� �nde,wnte Commission No. J eal)
T1 pl_PS Mr`'140 �lRublu
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REVIEWS FR T ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17