HomeMy WebLinkAboutBuilding Permit ApplicaitonAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
NIT
Permit Number: ✓�
ems'
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)452-1578 Commercial Residential x
PERMITTYPE: Electrical h6AKz&)r11 [k( ,A
PROPOSED IMPROVEMENT LOCATION: I
addrwcc FJ S Bq K Pam44 e S A i ! 04
Property Tax Ill -- -t 5 ` Q 1' 0S rl'S" Ci0 Z1- Lot No.
Site Plan Name: Brown Block No.
Project Name: Brown
I DETAILED DESCRIPTION OF WORK:
Remove existing service and replace with new 200 AMP meter main combo
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
,Mechanical _ Gas Tank Gas Piping Shutters
XElectric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 2100
N/A
Sq. Ft. of First Floor: 1428
— Windows/Doors
Roof
Utilities: _Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name James M Brown
Address: 123 E Division Rd
City: Valparaiso, IN State: _
Zip Code: 46383 Fax:
Phone No.
Name: Donald B Green
Company: Don Green Electric
Address: 1305 W 1st Street
City: Port Pierce State: FL
Zip Code: 34982 Fax:
Phone No772-418-5739
E-Mail dongreenelectric@gmail.com
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above]
State or County License EC13007447
It value of construction is $Z500 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 CONSTR ION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
of Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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
ON THE JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INTEND TO OBTAIN FINANCING, CONSULT
ITH OUR LENDFJR OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT_"
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�JL!cen�seHold�er���
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contrlc
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The fprgoing instrument was acknowledged efore me
this day of ZOby
The fQr Ding instrum nt was acknowledg d before me
this !� day of 21 by
`
Name of person making statement.
Nomc of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Ty a of Identification
Type of Identification
Pr
Pro d
( na r' of Notary F 1t42
Aft
(Sign ure Nota Q� g xpires
my Commission Expires.
Januar .5, 2D2ii
Commission No. Jame l
Commission No. Sea
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. L/ // 17