HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential X
PERMIT TYPE: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 5. Oc-an Dr., Lot #727, Jons•n Brach, FL 34957
Property Tax ID #: 4511-805-0128-000-5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove existing compromised power pedestal and provide and install new power pedestal
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping Shutters
X Electric — Plumbing — Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1,500.00
Generator
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
OWNER/LESSEE: CON
Name Russoll Pgott Namr
Address: 10701 S. Op -an Dr. Lot #727 Comb
City: Jenson Beach State: FL Addrf
Zip Code: 34957 Fax: City:
Phone No. Zip Cc
E-Mail: Phon(
Fill in fee simple Title Holder on next page ( if different E-Mai
from the Owner listed above) State
Lot No.727
Block No.
Windows/Doors
Roof Pitch
Building Height:
TRACTOR:
Michael Dale Ault
any.Ault Bros, Inc_ Electrical contractor
ss: PO Box 1528
'Ort Salerno State: FL
de: 34992 Fax:
N o 772-283-5520
aultbros@yahoo.com
)r County License EC0001693
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
Name:—
Address: -
City:
Zip:
Phon
FEE SIMPLE TITLE HOLDER:
Name:_
Address:
City:
Zip:
Phone:
State:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
Not Applicable
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."
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIQA
COUNTY OF ; _ COUNTY OF
The Forgoing instrument was acknowledged before me The f rgoing instrument was acknowledged before me
this- -;,/ day of i 2Q=L by this day of i� r, �. 20 1`t by
IAJ
Name of person making statement. Name of person making statement.
Personally Known .1 OR Produced Identification
Type of Identification
Produced
(Signature of Not r aublic-State of Florida )
A a � � _
� !Y
COmmISSIOn NO. rA Natarypublic5l to %
r L Mason
�i MY Commission GG 316460
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Personally Known - ' OR Produced Identification
Type of Identification
Produced /?
(Signature of
iVY Notary pubtic State of Florida
Commission No. :� Diana L Mason ( p
mission GG�9oWC
. Expires 03/26/2023
1PERVISOR PLANS I VI
REVIEW REVIEW
GETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW