HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/26/2019 Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMITTYPE: Temp Power Pole
PROPOSED IMPROVEMENT LOCATION:
Address: 7180 S. US Highway 1, Port St. Lucie, FL 34952
Property Tax ID #:
Site Plan Name: _
Project Name: —
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK: I
Temporary power pole to support construction
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
X, Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1,000.00
Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name HSC Port St. Lucie, LLC
Name: Daniel Gwizdak
Address: PO Box 130
Company: Valdan Electric
City: Daphne State: FL
Zip Code: 36526 Fax: (251)217-2867
Phone No. (251) 380-8375
Address: 338 19th St
City: Atlantic Beach State: FL
Zip Code: 32233 Fax: (228) 284-0694
Phone No (228) 284-0705
E-Mail: bobby@fulcrumgroup.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail bonita@griffithiIc.net
State or County License EC 13002670
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: x Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: X Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zi p: 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."
Signature of Ow / Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
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