HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/15/2019 Permit Number: otO 4?°` D'.$
RECEIVED
COUNTY
mommummumommAID-
A Building Permit Application APR 1 'R
Planning and Development Services Perititing Department
Building and Code Regulation Division St.4 ueCI CCP.nry
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 4910 Deanna Lane Fort Pierce Fl 34946
Property Tax ID#: 1430-702-0017-000-1 Lot No.1
Site Plan Name: Block No. 3
Project Name:
DETAILED DESCRIPTION OF WORK:
rebuild electric service r S'0 Ainp
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _I/Electric —Plumbing —Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 800.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Kelly Serafini Name:Daniel Stubbs
Address:4910 Deanna Ln Company:S&W Electric Inc
City: Ft.Pierce State:_ Address:501 W Coker RD
Zip Code; 34946 Fax: City: Ft.Pierce State:A
Phone No.772-349-0366. Zip Code: 34945 Fax: 772-464-4273
E-Mail: i:... . . Phone No772-464-6466..... .I
Fill in fee simple Title Holder on next page (if different Emaiistuboutelectric@aol.com
aol.com
from the Owner listed above) State or County License30071
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 LIEN LAW INFORMATION: •
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
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signa ure oder Lessee Contractor as Agent for Owner Si ature of Contra or License Holder
g / g g or/
License
OF FLORIDA sv „,- ( �� STATE OF FLORIDA1COUNTY OF �\ COUNTY OF
The forrging instrument as acknowledged before me The forge.• instrument was acknowledged b fore me
this I day of ��_ ,20by this /Utiay of ! )�� ,20_y'
ZQ‘c\\\- -V 5W4).5 s\ c), Q.L 51\–kA\.0\35
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 ( - f" _ Produced / ( f)L
(Signature of Notary Public-State of Florida) (Signature of Notary Public-S ate of Florida)
`�\\VYP�'�
Commission No. ,,� �e'% ELL�ay�gUGHN Commission No.
ate of Florida-Notary Public """' ELLEN AUGHN
_• � �``S�Y P`B'i
Commission # GG 270079 s° ��`State of Florida-Notary Public
My Cerirniss on Expires Co i iniaaiun # GG 270079
P �' `�f' M Commission _ res
�, October 22, 2022 %� �� oQ�;� y
REVIEWS F' =.af,.�R PLANS VEG AVON SE/bTtl�B�rl , �9 ANG f OVE
COUNTER REVIEW REVIEW REVIEW REQ,
DATE
RECEIVED
DATE
COMPLETED
ley. 2/7/19