HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ��� Ort
SS RECEIVED
w ,w , M Building Permit Applicatin FEB o
7 2020
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:Electric
Address: 3107 S Indian River Dr Fort Pierce, FL 34982-7746
Property Tax ID#: 2426-122-0002-010-6 Lot No.
Site Plan Name: Block No.
Project Name: Greenfield
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Install 120V 20AMP dedicated GFCI circuit
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Additional work to be performed under this permit–check all that apply:
;;Me.*anical _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: $ 700.00 Utilities: —Sewer _Septic Building Height:
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Name Nancy P Greenfield Name:Walter Nasi
Address:3107 S INDIAN RIVER DR Company:Sol Electric LLC
City: Fort Pierce State: Address:5500 SW 43rd Ter
Zip Code: 34982 Fax: City: Ft Lauderdale State:FL
Phone No.772-216-7027 Zip Code: 33314 Fax:
E-Mail:N/A Phone No754-423-4107
Fill in fee simple Title Holder on next page(if different E-Mailwnasi72@yahoo.com
from the Owner listed above) State or County LicenseEC13008044
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.
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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 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR OTICE OF COMMENCEMENT."
Signat e f Ow r/Lessee/Contractor as Agent for Owner Signatur , f Contractor/License Holder
STATE OF FLOAT A n GLF�Lt,J�O,
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COUNTY OF�Q/�5j /�iW COUNTY OF
The forging instrument was acknowledged before me The for oing instrumen as acknowledged before me
thi: r� day of 7��J A,l 20 570by this day of 20 0 by
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Name of persoA making statement. Name of person making statement.
Personally Know Produced Identification Personally Known�OR Produced Identification
Type of Iden t' cation Type of Identifica
Produced Produced
No ublic State Notary Public State of Florida
(Signature o t CKER (Signature ary e 2 ,bn GG 049422
,p mission GG 049422 y
OF Expires 11/21/2020 4 Expires 1tl2112020
Commission No. Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Key. 217119