HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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) 462-1578 Commercial Residential X
PERMIT TYPE: Electric
PROPOSED IMPROVEMENT LOCATION: -
Address: 3200 S 7th ST Lot 85
Property Tax ID #: 2427-601-0060-000-0
Site Plan Name: Lot 85
Project Name: Lot 85
DETAILED DESCRIPTION OF WORK:
repair damaged meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit --check all that apply:
,Mechanical — Gas Tank _ Gas Piping _ Shutters
Electric — Plumbing Sprinklers Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 500 Utilities: —Sewer _Septic
Lot No._
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
NameWindsong Owner LLC
Address:1750 S Telegraph Rd #106
City, Bloomfield Hills, MI State:
Zip Code:48302 Fax:
Phone No.
CONTRACTOR:
Name: Donald B Green
Company: Don Green Electric LLC
Address: 1305 W 1st Street
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone N0772-418-5739
E-Mail:
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
E-Mail dongreenelectric@gmaii.com
State or County License EC13007447
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: A,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
WITA YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Sign ure of Owner/ Leessee n ac o as Agent for Owner
Signature of Contractor/Licen a Hol
STATE OF FLORIDA
STATE OF FLORIDA „ram, f
COUNTY OF
COUNTY OF !f�
The f ing instru t was acknowledged before me
this day of 202Dby
The forg prig instru . t as acknowledg before me
this day of � W by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
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( i to of Notary ice, a e 611 of F
Joy Christie Copeland
Camm15Slan Na. My Cc r�g� Go 937762
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(SignaiTe o Notary at a i= '
Joy C Copeland
Commission No. My C 937762
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