HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 ad Permit Number:
RECEIVED
• N
J 2 2020
- - - Building Permit Applicatio AN
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XXXXX
PERMIT TYPE: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 5813 Birch Drive Ft Pierce
Property Tax ID#: MLS ID: RX-2363628 "'�"�d`a ��bq . ej ie,, d d 0 –y Lot No.
Site Plan Name: Block No.
Project Name: Brian Bollman Home owner
DETAILED.DESCRIPTION OF WORK:
Chande service from 100 amp tp 200 amp Upgrade wiring in home bring home up to code
CONSTRUCTION INFORMATION:
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: 1100 sg ft Sq. Ft.of First Floor:
Cost of Construction:$ 2400.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name 1?9 1 CW Rat, N ay Name:Robert T Payuk
Address:—'!;43 t 1 w Company:Payuk Electric LLC
City: U/C- State: Address:2501 SE Calusa Ave
Zip Code: Fax: City: Port Saint Lucie State:FI
Phone No. 77?,— Zip Code: 34952 Fax: 772-335-1639
E-Mail: Phone No 772-337-4197
Fill in fee simple Title Holder on next page(if different E-Mail bobtoml2@bellsouth.net
from the Owner listed above) State or County License Ecl3001275
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: .
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 thepermit 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 THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING CONSULT
WITH YOUR LENDER 0jaWATTORNEY BEFORE RECORDING YOUR NOWE OF COMMEN NT."
///�"�"'Z/ey ��/e
Sign atur O er/Lessee/Contractor as Agent for Owner Signature of ntra r/L'c` se Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF :�> COUNTY OF ---, ,s'• LSci�
The forgoing instrument was acknowledke�before me The forgoing instrument was acknowledged before me
thisa. day of 7Q0'\ 20_ by this?:nL day of 20Za by
Name of person making s atement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced L--
(Signature of Notary lic-State of Florida) GN�Ns (%nature of - to it�4lN4�� 0��2� i?
NASp`zIE GGp?20 3 .o...'. �'1 MY COMMISSION G 2070
Commission No da' �- SedT N4�ISSION#e�go,20r0CGA' fission No b IRES:Oe� �r dsr•,it ",
y PU .{ OM' e�mb ndo �!.�3 s: _?- na
r•• B`os� M IRE$: MpobpcV` </v �.oe: sondedTO
?x° FXP Nola °:
;...''.oec gor
REVIEWS FRONT l' UPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.