HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 2
Date: 6/1,4/2019 Permit Number: 'lD� ' 034
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: emergency meter replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 4495 gator trace blvd
Property Tax ID#: Zq 3q r 'roq—000 —'u®��
Site Plan Name: Casa-mae farms
Project Name:
,'DETAILED DESCRIPTION -OF WORK
existing meter burned up, replace with new 200 amp meter, upgrade grounding system to current electrical code.
CONSTRUCTIONINFORMATION:
Lot No. 1casa
Block No.
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:
Cost of Construction: $ 1000.00 Utilities: —Sewer _Septic Building Height:
:OWNER/LESSEE:
CONTRACTOR:
Name Joan Barbella
Name: John Lotak
Address: 4495 Gator Trace Blvd.
Company: John Lotak Electric Service
City: Fort Pierce State: _ "
Address:1161 SE Proctor Ln
City: Port St Lucie State: FI ,
Zip Code: 34982 Fax:
Phone No. 772-528-9457
Zip Code: 34983 Fax:
Phone No 754-264-3089
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail johnlotakelectricservice@gmaii.com
State or County License EC#13008663
from the Owner listed above)
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 TITLEHOLDER: _ 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.
1 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."
Signature ly Owner Lessee/Contractor as Agent for Owner
Signatur f Contractor/License Holder
STATE OF FLORIDA
FLORIDA
STATE OF FLORIDA�p 1
COUNTY OF �,1
COUNTY OF I XXr .
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of . 20_ by
AQfte, V ,
this day of 20_ by
Drk�n dDt"
Name of per n making statement.
Name of pers n making sta ement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Sig atu a of Notary Public- StAte of Florida)
( ature of Notary Public-'S a of Florida )
Commission No. (Seal)
Commission No. NG
ii�GRA7,JGG
fit:
. u r iv9P111SSi0K 275060
_°-
AHyAIWG
,•z• E
Dew e
PIFES: •oUn
eiwnters
REVIEWS
.=FF p i ��:
�
i i i0lv�l
�� I R
PLANS
VEGE.-%.NfdNJ,n
ec6EAN
OVE
cemb
r`2�
REVIEW
Ifi _ -
REVIEW
DATE
�,.. •.: E::� °:
nded Thru
RECEIVED
;.:.:--w -"�
DATE
COMPLETED
Rev. 2/7/ 19