HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `�C�E
Date: MARCH 10 2020 Permit Number: �
C A V Ca
Building Permit Application MAR 10, 2020
Planning and Development Services
Building and Code Regulation Division Permitting e pal L e nt
2300 Virginia Avenue,Fort Pierce FL 34982 c J� ,Icy erg U rl�y
Phone:(772)462-1553 Fax: (772)462-1578 Commercial � la`7C_.._.....____.__._._..____..
FL
PERMIT TYPE:ELECTRICAL
PFROPOSED`(IVIPROVEMENI'LOCATION �'r �`� � �
Address: 3319 COLUMBRINA CIR
Property Tax ID#: 3425-703-0014-000-3 Lot No.35
Site Plan Name: CAROL BRADLEY Block No. 10
Project Name: BRABLEY RESIDENCE
DETAtLD
`ED ESG8IPTION OF WORK4
EXACT 200 AMP 240 VOLT METER/MAIN CHANGE OUT
5Tt 'S*
C1N$TRUCTIQN fNFORMATION �
,.
Additional work to be performed under this permit–check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2100.00 Utilities: —Sewer _Septic Building Height:
CWNERjLE5fEs �
ONTRACTOR „ r
Namepp__ Name:WALTER RUNGE
Address ') ➢�1 �� �� J��� Company:COASTAL ELECTRICAL SERVICE INC .
City: 96State: t`\ Address:2155 SW GULL HARBOR LANE
Zip Code: 3 rf Sti Fax: 14 City: PALM CITY State:FL
Phone No. / Zip Code: 34990 Fax: 772 286 5766
_
E-Mail: Phone N0772 286 570
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Fill in fee simple Title Holder on next page(if different E-Mail richard@coastalelectricalservice.com
from the Owner listed above) State or County License EC13001456
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.
SUPPLE'MEN'TAL CONSTRUCTION`LIEN LAW INFORMATION 3 4
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 RE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AITORNEY BEFORE RECORDING YOUR NOTICE OFC NCEMENT."
A, / V
Signature of Owner/ ssee/Contractor as Agent for Owner Sign ure of Contractor/License Holder
1411" 4 -
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledg d efore me The for oing instrument was ackpowledged before me
this 10 day of YYl AZIC,H+ 20Vby this � day of 0l09deC_4+ ,20.20 by
Iwo 14t Y J& A i+e r
Name of person making statemen . Name of person making statement. /
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
42� e"Z24,0 l -
(Signature of No ry Public-State of Florida) (Signature of N ry Public-State of F o
a 11 1AUDREY B.HUM RE
Commission No.. M !?? AUDREYE HREY Commission �= MMISSION# 17
MY COMMISSION#GG 300817
EXPIRES:March 6,2023
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REVIEWS OR PLANS O SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.