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
PERMIT TYPE: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 8006 Banyan Street
Property Tax ID #: 1301-603-0088-000-8
Site Plan Name:
Project Name: Jasmer
DETAILED DESCRIPTION OF WORK:
Change out electrical riser / no service upgrade
CONSTRUCTION INFORMATION:
Commercial Residential %C
Lot No__
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
Total Sq. Ft of Construction: _
Cost of Construction: $ 450.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Joseph & Vickie Jasmer
Name:William Buehler
Address:8006 Banyan Street
Company:All American Air & Electric
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No.772-878-5143
Address:4115 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34061 Fax: 772-878-5144
Phone No772-878-5143
E-Mail: vickiewood8@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailgcalhoun@aaaeinc.com
State or County License EC0002438
If value of construction is $2500 or more, a RECORDED Notice of c,ommencemeni is requireu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip:
Phone
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
State:
Address:
City: State:
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
w1TH 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 FLO IDA -
STATE OF FLORIDA ,
COUNTY OF -b-Lek(,
COUNTY OF , Lij rAr.,,
The forgoing instru ent was acknowledged before me
The forgoing instru ent was acknowledged before me
this day of 20�° by
_-�I///&A
thi//s / /� day of 20f� by
�FJl/� .1&4 er
Name of person making statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known !i OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/ 19
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982
772-462-1672
FAX 772-462-1148
AUTHORIZATION FORM FOR CREDIT CARD PAYMENT — CONTRACTOR
LICENSING
TO: St Lucie County
RE:
Permit #
Credit Card Users: 1.5 Surcharge added per transaction.
Payments must be received in this department by 4:00 PM for transaction to be
processed that day, if not it will be processed the following business day.
VISA MASTERCARD DISCOVER
Credit Card Number
Expiration Date C:J-0 ITC- Zip Code �-
3 digit security code L `7 17
Amount $ + 1.5% surcharge =
Business Name: ��� � %"��"� ��L-� A" �-
Authorized Signature:
Print Name:
Phone: (-2 � ) � i 1
Fax: (i 7 )
Comments:
SLCPDSD Revised 4/01/2013 EN