HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED,FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
RECEIVE
Planning and Development Services JAN 1
Building and Code Regulation Division 2019
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial ResiderikLucie County, Permitting
PERMIT TYPE:ELECTRICAL
PROPOSED.IMPROVEMENT LOCATION d °K
F
ll
¢ d..
Address: 3039 SUMMIT STREET
Property Tax ID#: 2421-703-0017-000-9 Lot No.2
Site Plan Name: Block No. C
Project Name:
DETAILED DESCRIPTIONnOF WORK
ELECTRICAL SERVICE CHANGE;INCLUDES MAIN PANEL,METER AND GROUNDING
CONSTRUCTION INFORMATION 3 E
Additional work to be performed under this permit—check all that apply:
IV�echanical _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:$ 2835.00 Utilities: _Sewer _Septic Building Height:
;OWNER/LESSEE � �' f° ;� CONTRACTOR � - s
NameRAYMOND WILSON Name:PUBLIO STERLING
Address:3039 SUMMIT STREET Company:MR. ELECTRIC OF PORT ST LUCIE
City: FORT PIERCE State:_ Address:5994 NW BAYNARD DRIVE
Zip Code: 34982 Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34986 Fax:
E-Mail: Phone N0772-777-5678
Fill in fee simple Title Holder on next page(if different E-MailMR.ELECTRIC.PSL@GMAIL.COM
from the Owner listed above) State or County License29955
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 F s �`
u
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY _Not Applicable
Name: Pr Name: IV Pt
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.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 PAYNG
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
WRH YOUR LENDER OR ANATTORNEY BEFORE RECORDING YOUR NOTICE OF COOMENCEMENT.7
Signature of Owner/Lessee/Contractor s Agent for Owner Signature of Contractor/License Holder,
STATE OF FLORIDA 11 STATE OF FLORIDA
COUNTY OF �T• L UC,(� COUNTY OF 4
The for oing instru ent was acknowledZ�y
fore me The f oing instru ent was acknowledgedbefore me
this day of 2this day of 20by
e:j( 16 el I
Name of—person-making statement. Name of person making statement. /
Personally Known OR Produced Identification V/ Personally Known OR Produced Identification
Type of Identifi at♦ n Type of Identificatio
Produced ' Produced L
bL
i
Vv
4MA,a4rt-Er�eof, ota Pub ic-S a (Signature of Notary Public-State of Florida)
KAREN S. NIELSEN KAREN S. NIEL�
ComSam
f F1nrirla-Notary Purls ) Commissi �� °�e''.
: �" ?i of a-Notary u I
Commission # GG 207484 =* ►__ Commission #GG 207484
? M Commission Expires ;�
June 12 June 12, 2022
REV ZONING SUPERVISOR PLANS ANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.