HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Ig
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Date: 05/d/2019 Permit Number: S_ V
�-� RECEIVED
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Building Permit Applicatio
MAY 13 2019
Planning and Development Services ST. Lucie County,Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _
PERMIT TYPE:Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 11000 S OCEAN DR 5-E
Property Tax ID#: 124869 .1 ( �)( �.('�� Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
REPLACING 100 AMP MLO ELECTRICAL BREAKER PANEL LIKE FOR LIKE
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
XElectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1,000 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameSUSAN HALLMAN Name:VINCENT BROWN
Address:20932 COX MILLS CT Company:BROWN ELECTRICAL SOLUTIONS
City: ASHBURN, VA State:_ Address:1421 W 13TH STREET, SUITE#104
Zip Code: 20147-4812 Fax: City: RIVIERA BEACH State:FL
Phone No. Zip Code: 33404 Fax:
E-Mail: Phone N0561-557-2011
Fill in fee simple Title Holder on next page(if different E-Mailbrownelectdcal0l@yahoo.com
from the Owner listed above) State or County License EC#13007775
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 RECO DiNf.YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Cont r fora gent for Owner Signature of Contractor/License d
STATE OF FLORIDA STATE OF FLORIDA ff
COUNTY OF +-,4LK t��n,✓r� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 7 day of MA-1 ,2011 by this 7 day of NLA`/ ,20±1 by
\41tuem-t 'REowioiJ -'s2- Uc.E�4? Suwti.l Uiz--
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification x Personally Known OR Produced Identification
Type of Identification Type of Identification
ProducedProduced 8G,50 `872' 80—N(S`a
C!JA -#W V%L Notary Public State of Florid
(Signature ofNotary Public-St ( i ature of N tary Pub ic-S to o►idI ipa Rolle
Jar Notary Public State of Florida Commission GG 214687
-� y P�yllipa Rolle or Expires 05/18/2622
Commission No.
c ea Commission GG 2146f 7 C ission No. 2i yb
orw
Expires-05/18/262-2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19
REOEIVED
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ST. Lucie County,l Permitting
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