HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMITTYPE: Electric
PROPOSED IMPROVEMENT LOCATION:
Commercial Residential X
Address: 118 SE Camino St Port St Lucie, FL 34952
Property Tax ID #: 3419-515-0259-000-6
Site Plan Name: Camino
Project Name: Camino
DETAILED DESCRIPTION OF WORK:
150 AMP service change - like for like
CONSTRUCTION INFORMATION:
Lot No. 9
Block No. 30
Additional work to be performed under this permit —check all that apply:
_Mechanical Gas Tank —Gas Piping _ Shutters Windows/Doors
)C Electric _ Plumbing — Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2100
1544
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
i./Y NER)1..E$SEEr
CONTRACTOR
Name Denise Parker
Name: Donald B Green
Address: 118 SE Camino St
Company: Don Green Electric LLC
City_ Port St Lucie State: _
Zip Code: 34952 Fax:
Phone No.
Address: 1305 W 1sr Street
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No 772-418-5739
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above]
E-Mail dongreenelectric@gmail.com
State or County License EC13007447
If value of construction is $25W or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,50ti or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: ^ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City: State:
Zip: Phone:
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 tnatca7ma.
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
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
vormn wauin . eunrn nD AN ATFnDMFV RFFARF RFrnRDING YMR NOTICE OF COMMENCEMENT. -
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of contractor/License Holde
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
29th January 2014(-Ay
this 29th day Of January , 2012j>y
this day of
Name of person making statement.
Name of person making statement_
Personally Known OR Produced Identification
Personally Known` OR Produced Identificatio
Type of Identification
Type of identification
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Pr uc d
re of Notary P b - Ra c &tana of Florlds
{Signa e o a ary I t t !a
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.lay Christine Copeland
' luty Ion GG 9377'S2
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C mission NO. Exp 612024
Commission NO.
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