HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:�f- Z , ;)o-aci Permit Number: oc:��3"��
EIVED
Building Permit Application h
Planning and Development Services Permitting Department
Building and Code Regulation Division
St.Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:Electrical
PROPOSED]MPROVEMENT LOCATION:
Address: 10851 S Ocean Dr q
Property Tax ID#: �5 ��-`�dd1"bdd5" odtl ' I -Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF�WORK:
Replace electrical panel in clubhouse
CONSTRUCTION INFORMATION:
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:$ 1,000 Utilities: —Sewer —Septic Building Height:
OWN.ERAESSEE: CONTRACTOR:
Name Windmill Village by the Sea Name:Angel Romero
Address:10851 S Ocean Dr. Company:CPS Electric, Inc.
City: Jensen Beach, FI State: ff-- Address:100 NW 28th Ave.
Zip Code: 34957 Fax: City: Miami' State:FI
Phone No.772 229-1145 Zip Code: 33125 Fax:
E-Mail:oscar4141@msu.com Phone No 3059629742
Fill in fee simple Title Holder on next page(if different E-Mail cpselectric1 @gmail.com
from the Owner listed above) State or County License EC13005401
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.
�S'tJPPLE�IUIENTA�L'OhNSTRU"CT'ON�LI`EN�LA�111/�INF��ORIVIA�TION` .�, �} .� �: � �y �
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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 IMP���MAN
O YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTE U THE JOBTT SITE BEF RE THE NEY BEFIRST ORE RECORDINGNYOUYOU IN1EkD TO CE FCO OBTAIN FINANCING, CONSULT
WITH
Signature of Owner/Lessee/Contr'actor as Agent for Owner Signature of Co ct License Holder
STATE OF FLORIDA STATE OF FLORI►��jjpf� /�
COUNTY OF �� �-u C1,�1 L COUNTY OF
The forgoing instrument was acknowledged before me The f going instrument was acknowledged before me
this day of Ft 6 2C6 by this o day of �/1 „ O-4zwy
Name of person making statement. Name of person making stet ent.
Personally Known OR Produced Identification ✓ Personally Known "' OR Produced Identification
Type of Identifitation - Type of Identification
Produced Produced
ry � _ 4 ORO�o8536
P del k11AC_9S dt@,�of rida) (Signature of Notary 3
M,* Expires 0411212024 0
(Seal) Commission No. E eal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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