HomeMy WebLinkAboutKESSLER PERMIT APPALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/9/19 Permit Number:
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 APPLICATION FOR: Electrical
Address: 9450 MEADOWOOD DRIVE UNIT 102 FORT PIERCE, FL 34951
Property Tax ID #: 1327-703-0026-000-3
Site Plan Name:
Proiect Name: RONY KESSLER - PANEL REPLACEMENT
Setbacks Front Back: Right Side:
REMOVE &REPLACE PANEL
Left Side:
Lot No.
Black No.
OHVAC ❑Gas Tank ❑Gas Piping ❑_Shutters ❑Windows/Doors
❑✓_ Electric ❑ Plumbing ❑Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1395.00
S Ft. of First Floor:
_
Utilities: Sewer ❑ Septic
Building Height:
Name RONY KESSLER
Name: GARETT GUIDROZ
Address:861 HEMLOCK STREET
Company: COMPLETE ELECTRIC, INC.
City: FRANKLIN SQUARE
State:NY
Address: 637 SEBASTIAN BLVD
Zip Code: 11010 Fax:
City: SEBASTIAN State: FL
Phone No. 516-369-2376
Zip Code: 32958 Fax: 772-388-2411
Phone No. 772-388-0533
E-Mail: RONYROTARY@AOL.COM
Fill in fee simple Title Holder on next
page ( if different
E-Mail: mcook@completeelectricinc.com
from the Owner listed above)
State or County License: EC0001911
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL �ONS7FtUGTIOL�
LIEN [AW [NFQRMATI(Xl�
= =
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 Count yy 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent
STATE OF FLORIDA
COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me
Yllls 9 day Of DECEMBER ZQ� by
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF sr Lucie
The forgoing instrument was acknowledged before me
this s day of DECEMBER 2O by
GARETT GUIDROZ
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
(Signature of Notary Public- Stara of Florida 1 _ _ (Signature of Notary Public- State of Florida
Commission No. ccszsesa
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