HomeMy WebLinkAboutBuilding Permit Application C( g o ` O5-6)
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/22/2019 Permit Number: I1 ?0) '6110
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___ .M- 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 TYPE:ELECTRICAL WORK
I'PROPOSED INPROVEMENT LOCATION . '
Address: 35 SOVEREIGN WAY FORT PIERCE FL 34949
Property Tax ID#: 1414-701-0072-000/1 K
Lot No.
Site Plan Name: Block No. 8
Project Name: DOCK AND BOAT LIFT ELECTRIC POWER SUPPLY
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dETAILED,DESCRiPTION OF-,
F WORK; 4
REMOVE EXISTING 3 LIGHTS FIXTURE AND REINSTALL 2 AT NEW RELOCATED SPOTS RELOCATE ONE GFCI
OUTLET ON PIER, 208V 15 AMP POWER SUPPLY TO BOAT LIFT
CONSTRUCTIoN:INFORMATION .. r '
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: 1
l
Cost of Construction:$ 1000 Utilities: Sewer _Septic Building Height:
OWNER/LESSEE ,: *, _ CONTRACTOR (e1
NameATUL KELUSKAR Name:
Address:35 SOVEREIGN WAY Company:
City: FORT PIERCE State:_ Address:
Zip Code: 34949 Fax: City: State:
Phone No.6462087435 Zip Code: Fax: Ij
E-MaiI:ATUL.KELUSKAR@GMAIL.COM Phone No .1
Fill in fee simple Title Holder on next page(if different E-Mailli
from the Owner listed above) State or County License
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
.'SUPPLEMENTAL CONSTRUCTION
_ . L-:,IEN LAWfINFORMATION oT
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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:
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
I 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 your Notice of Commencement.
1 --014A- C),(A/12"'
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDI STATE OF FLORIDA
COUNTY OF ..J1-'l u_l',VZ. COUNTY OF
The for1.ping instrume t w.s acknowledgl before me The forgoing instrument was acknowledged before me
this()) day of
eiUeJL .' 20by this_ day of ,20� by
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Name of person m. in: statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced IVY bL. Produced
iAl
(Signature of Notary PubIi e of Florida) (Signature of Notary Public-State of Florida)
Commission No. - • ... ,. „ , _ Commission No. (Seal)
,o.is'P,40% ELLEN VAUGHN
:=°jt.,,State of Nod.=-., = - •_ .
,_______-
1:;,,,,677,...E.: ommission #03 270079
REVIEWS F'1lh; 9tMyr` ;"
si rRiRV1`OR PLANS VEGETATION SEA TURTLE MANGROVE
-• :;: 2 REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ley.9/26/18