HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/27/2020 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 no Residential yes
PERMIT TYPE: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 705 E Midway Road
Property Tax ID #: 3402-606-0163-010-6 Lot No.8
Site Plan Name: INDIAN RIVER ESTATES UNIT 5 Block No. 26
Project Name: EMERGENCY METER REPLACEMENT
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REMOVE AND REPLACE EXISTING 200A ELECTRIC METER CAN 1,) 79 r
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: NA
Cost of Construction: $ 1400.00
Sq. Ft. of First Floor: NA
Utilities: _Sewer _Septic Building Height: NA
OWNER/LESSEE:
CONTRACTOR:
NameLeo Mashaw
Name: Kenneth A Geremia Jr.
Address: 705 E Midway Rd
Company:Gerelco Electrical Contractors, Inc.
City: Fort Pierce State: 1,
Zip Code: Fax:
Phone N0.772-828-1722
Address:560 NW Enterprise Dr.
City: Port St Lucie State: FL
Zip Code: 34986 Fax: 772-340-7475
Phone No 772-340-7474
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail sblackford@gerelco.com
State or County License EC13003415
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.
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: Gereico Electrical contractors, Inc.
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 560 NW Enterprise or
Address:
City: Port St Lucie State: FL
Zip; 34986 Phone 772-340-7474
City: State:
Zip; Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 NOTICE OF COMMENCEMENT."
Rev. 2/7/19
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Sign?t re of Owner essee on 6ctor as Agent
Signature of Contr '#or/License Hold r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF4 . lass@
COUNTY OF St Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisZ-� day of F-�b� 20 Z-; by
this 25th day of February 202a by
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Name of person making statemen .
Name of person making statement.
Personally Known ! OR Produced Identification
Personally Known YeS OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Signature of N~ P li -State o Ffrn
(Signa ure of Notary Public- St t o F i a
Notary Public $$a�t�e Florida'
Commission No. • • F. DeLXtea4l
Commission No. Notary public 6�
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MY Commission GG 989826
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Expires 07/06/2024
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DATE
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DATE
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Rev. 2/7/19