HomeMy WebLinkAboutBuilding Permit ApplicationAIIAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Permit Number:
Building Permit Application
Plonning ond Development Services
Buildinq ond Code Regulotion Division
2300 Virginio Avenue, Fort Pierce FL 34982
Phone: (772\ 462-1,553 Fax: (772) 462-t578 Commercial Residential x
PERM lr rYPE: EleCtriCal
PROPOSED IMPROVEMENT LOCATION :
Address: 5506 &eander Ave, Ft Pierce, Fl34982
Property Tax lD #:341 0601 00020007 Lot No.2
Site plan Name: Hassan Residence Block No. 1
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace 200amp exterior panel and upgrade grounding. No work to meter is figured.
lnstall surface mount junction box on exposed wire sticking out of wall near AC unit.
CONSTRUCTION I N FORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
_ Gas Piping _ Shutters _ Windows/Doors
_ Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction:5q. Ft. ot Flrsr Floor:
Cost of Construction' 5 1338 00 Utilities: _Sewer _SePtlc Building Height:
lf value of construction is 52S00 or more, a RECORDED Notice of Commencement is required'
lf value of HVAC is S7,5OO or more, a RECORDED Notice of Commencement is required'
OWNER/LESSEE:CONTRACTOR:
53mg Monwara Hassan
Address:758 Bent Creek Dr
1-;1,,. Fort Pierce State:
Zip Code: 31947 Fa x:
phone 11e. 772-834-0565
g-1y, ; 1. faizam786@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:Kent Blosser
Com panv: Blosser Electric
Address: PO Box
City:Porl St Lucie trl5rare:' '
7tn CnAo. 34985 Fa x:
phone No 772-337-0055
E-14, ; 1 nrblosser@gmail.com
State or Countv License Ec13001570
,s
u p pst E M E N TA L icg+l{:TR
_u_c-Tlo N ;l| E N LAW
I
N F0 n rvrnrt o ru,. 4. :a
:::::
DESIGNER/ENGINEER: _ Not Applicable
Name:
Add ress:
City:State:
Zip:Phone
MORTGAGE COMPANY
Name:
_ Not Applicable
Address:
City:State:
zip:Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
zip:Phone:
BONDING COMPANY: _Not Applicable
Name
Add
tg,
tusr
City:
7ip:Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certifv that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countv makes no reoresentation that is srantins a oermit will authorize the permit holder to build the subiect structure
which is in conflict with anv dpplicable Home Owiers Asiociation rules, bvlaws or and covenants that mav 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, ldo hereby agree that lwill, 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
TTYICE FOR IMPROYETI|ENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE THE FIRST INSPECTION. IF YOU TO OBT CONSULT
WITH YOUR LENDER OR AN A BEFORE RECORDING YOUR OF COM
Signature of r/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
couNry oF S+ Lw\e
The forgoing instrument was acknowledged before me
this ?Sffdayof llte,rr-h ,20 lct bv
kr,"* H"oq*a
Name of person making statement.
' -/-
Personally Known l/ OR Produced ldentification
Type of ldentification
Produced
(Signature of Notary Public- State of Florida )
commission No. GGOql0 tO (seal)
ture of Contiactor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this lSh day of fl^qrcL , 20 ll by
L
Ke r't B lo sse n
Name of person making statement,
PersonallyKnown t/ O^Producedldentification
Type of ldentification
Produced
commission ru". GGQIL9LQ (Sea l)
hr f W^!,^-(Signaturebf Notary Public- State of Florida )
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
GUY R BOUCHER
MY COMMISSION # GG091810
qui RsoucHER
MY COMMlsSloN # 9G09t810