HomeMy WebLinkAboutPermit ApplicationAIIAPPTICABLE INFO MUST BE COMPTETED FOR APPLICATION TO BE ACCEPTED
Darc.3/31t2020 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-L553 Fax: (772) 462-t|t8 Commercial Resirlential x
PERMIT rYPE: EleCtriCal
PROPOSED I M PROVEM ENT LOCATION :
Address: 4711 Myrtle Dr.
Property Tax lD g' 3402-608-0074-000-8 Lot No. 19
Site Plan Name:Block No. 39
Project Name:Kane Residence
DETAILED DESCRIPTION OF WORK:
Correct Violations from St. Lucie Building Department:
lnstall knock out seal in front light by door. Replace AC disconnect. Sleeve AC electrical wire. Install new jelly jar light near back door.
Install dryer damper. Reattach low voltage service boxes. Strap (3) TV lines laying on ground to house.
CONSTRUCTION I NFORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters _ Windows/'Doors
_ Generator __ Roof __ Pitch
Total Sq. Ft of Construction:Sq. Ft. of First Floor:
Cost of Construction. 5 658.00 Utilities: _ Sewer _ Septic Building Height:
lf value of construction is SZSOO or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:CONTRACTOR:
Name Stephen Kane
Address: 1437 Chobee St
6;ry. Okeechobee State:
ZiP Code: 34974 Fax:
phone 116. 863-801 -1739
E-Ma i | : stephenk03 @earthlinknet
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Kent Blosser
Company; Blosser Electric
Address: P.O Box 7305
City:Port St Lucie Sitate: FL
ZiP Code: 34985 Fax:
phone yo 772-337-0055
E-Mail nrblosser@gmail,com
State or County 116gnt. EC13001570
lf value of HVAC is $7,500 or more, a RECORDED Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESTGNER/ENGtNEER:_ Not Applicable
Name:
Address:
City:_
Zip: _
State:
Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:State:
zip:Phone:
FEE SIMPLE TITLE HOIDER: _ Not Applicable
Name:
Address:
City:
zip:Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
zip:Phone:
OWNER/ CONTRACIOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and instatlation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St- Lucie County.4akqg no repre:ientatign that is granting a permit will authorize the permit holder to build the subject structurewnlcn ls In conTllct wltn.any appllcaole Home uwners Assoctatron rules, bvlaws or and covenants that mav restrict or orohibit suchstructure. Please consult with your Home Owners Association and review'your deed for any restrictions vifrictr maf apply - --
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respercts, 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
"wARiilitc To
TWICE FOR
FAILURE TO RECORD A ilOTICE OF COiIMEITCEMEIIT IIAY RESULT Iil YOUR PAYIITG
TO YOUR PROPERTY. A TOTICE OF COMIIIEilCEiIHIUT MUST BE RECORDED AilD
POSTED BEFORE THE FIRST ITSPECTIOT. IF YOU TO OBTAtil FtNANCltc, COilSULT
WITH BEFORE RECORDIilG YOUR ,,
B SITE
OR AD
Signat-ure of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
Louru-rv or -':,F.- Lttd<
The f-orgoing instrument was acknowledged betore me
this 3D oayor MO"TCV\ ,zodobv
Name of person making statement.
(Signature of Notary
Commission No.
: of FlontutoN tilHSOH
r,lY Cor/MrsstoN * Gc 970043
_ €xPlr$e#|rch 16,2024
ilfild''jil ^l'hftr Netary Plbiic Urileivriters
Signatu re of Contractor/License Holder
STATE OF FLORITIA
aiiuN-rY dr -".S. I Urc'te
The forgoing instrument was acknowledged before me
this {) day of [t4OfC-lA zo&0 by
OR Produced ldentification
Name of person making statement.
MY COMMISSION # GG
(Sd|qrylREs: March 16, 2024
Bbnded Thru NotarY Public Undert/r
SEA TURTLE
REVIEW
DATE
COMPLETED