HomeMy WebLinkAboutBuilding Permit ApplicationAll AApi Iraw F IIUFn mi mT RF rnMpl 1PTFr1 FnR APPI irATIAN Tn RF ACCEPTED
Date:
Permit Number: Rk'olql
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: SERVICE CHANGE
PROPOSED IMPROVEMENT LOCATION �°
Address: 7906 HIBISCUS ROAD
Property Tax ID #: 1301-605-0206-000-8
Site Plan Name:
Project Name:
Replace existing Challenger panel with new Square D 42 Circuit panel with a 200 AMP Main breaker
Lot No. 6
Block No. 48
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: $ C) Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE
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CONTRACTOR
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Name: John Cavnar
Address: �' zw/iV ti 1/
Company: Goldstar Electric, Inc.
City: �,yiJ/�v� Stater
Address: 213 NE Sagamore Terrace
City: Port Saint Lucie State: FL
Zip Code: o Fax:
Phone No.
Zip Code: 34983 Fax:
Phone No 772-380-5913
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mailjohnc@goldstar-electricicom
State or County License EC13002082
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.
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. Plekase 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 DER AN ATTORNEY BEFORE RECORDING YOUR INOTICE OF MMENCEMENT."
t r er/ Lessee/Contractor as Agent for Owner
Si ature C ractor/License Holder
1Si
ATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFF I,. ,,c, Q ,
COUNTY OF 1
The forgoing instrument was acknowledLyed before me
The forgoing instrument was acknowledge before me
a. �S�
this � day of d 20 by
this_ day of 2011 by
Name o0person making statement.
Name of lerson making statement.
Personally' Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced—
Produced
aha } i
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(S to a of Notary Pu ic- S e of Florida)
(Signs ure of Nota "
.YP�•••.• LASWAHNAINGRAM•RAHMING
Commission No.
Commission No. =�: *'• WCOMMIS�GG275060
�GRAM.ItAHMING
w IRES. De wJ*20.2022
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