HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/09/20 Permit Number:
9�aU( R
O4
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electric
PROPOSED IMPROVEMENT LOCATION:
Address: 5865 JENKINS PARK AVE
Property Tax ID #: 2312-414-0028-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
replace 100 amp panel at detached garage. (meter can to remain)
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1000
Generator
Lot No._
Block No.
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Leslie Pfeiffer
Name: Daniel Stubbs
Address: 5865 JENKINS PARK AVE
Company:S&W Electric
City: fort pierce State: _
Zip Code: 34947 Fax:
Phone No. 772-216-1837
Address: 501 w coker rd
City: fort pierce State: fl
Zip Code: 34945 Fax:
Phone No772-201-7320
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail danstubbs33@gmail.com
State or County License 30071
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTG G ~�
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address:
City:
Zip: Phone:
A E COMPANY. — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name
Address:
City:
Zip: Phone:
_Not Applicable
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 grarting 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 Courry Amendments.
The foliowing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, wails. signs, raorrns a^d accessary uses to another non-residential use
"WARNM 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
MATH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
l
Signature
,,f -Ow .er/ Lessee/Contractor as Agent for Owner Signature of Con ractcr/License Holcer
STATE OF FLORIDA41 STATE OF FLORIDA
COUNTY OF___,_ . SU C l Q COUNTY OF
The f oing instru ent was acknowledged before me
this day of 2C ZQ by
PL \. IBX,
Name of person mak ng staterren;.
Personally Known ✓ OR Produced Iden:ification
Type of Identification
Produced
(Signa:ure of Notary Public- State of r
commission No co
—_y
REVIEWS FRONT ZONING
COUNTER REVIEW
DATERECEIVED
D.
DATE ----- -
COMPLETED
We_--r777P;_--- — — - - — —
The forgoing instrument was acknowledged before me
this _, cay of 20_ by
Name of person making statement.
Personally Known OR Produced Identification
Type of identification
Producec
LAURA R. CUBBE66Ea:ure or
Commission # GG 022076
Expires October if
W*d Thr.; Troy Fyn ha-wo 8*301011
'y Publ,c- State of Florida
SUPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW
(Seal)
SEA :TURTLE MANGROVE
REVIEW REVIEW