HomeMy WebLinkAboutApplication(1)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (Lk Wac'z1 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential YES
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 5605 East Wood Dr
Property Tax ID #: 1301-613-0394-000-7 Lot No. 6
Site Plan Name: Kimball —Service Change Drawing.pdf Block No. 154
Project Name: Kimball Service Change
Convert the Overhead service to Underground. Install new conduit and wire from existing meter location to the FPL pole
New Electrical Meter Second Electrical Meter,
Additional work to be performed under this permit —check all that apply:
Mec anical - Gas Tank _ Gas Piping _ Shutters
lectric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ II Q) , a�
Name Gary Kimball
Address: 5605 East Wood Dr
— Windows/Doors _ Pond
Generator — Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No. (772)224-1159
E-Mail: gkimba11504@gmaii.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Steve Courtney
Company: Courtney Electric LLC
Address: 9035 Americana rd. Ste # 15
City: Vero Beach A State: FI.
Zip Code: 32966 Fax:
Phone No 772-562-6048
E-Mail Steve@courtneyelectric.com
State or County License EC13006555
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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
BONDING COMPANY:
Name:_
Address:
City:_
Zip:
Phone:
_ Not Applicable
State:
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 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 Co m ment m esult in paying twi for
improvements to your property: A Notice of Commenc ment mus recorded in the publi` cis afSt.
Lucie County and posted on the jobsite before the first ' spe I you intend t In i ncing, consult
'th lender or an att—new before corn encin or or c in our Notice of me ement.
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Signature of Owner/ Lessee/Cont ctor as Agent for Owner =TE
Contractor/License Hol er
STATE OF FLORIDA FLORID
COUNTYOF ��1�I �'� RiVel COUNTY OF ►YN11cli I I�
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this � day of t ill ftf!, 2020 by this -U iiay of (%Jne. 2020 by
6QV s�qyf,� crAAy1 -cif
Name of person makingstatement. Name of person making statement.
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Personally Known C OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced ¢
ELI � �j/, I ' _U�ow -
(Signature of Notary Publi - tate of Flc�gi) (Signature of Notary Public tate of Flo �� )
io<,�,,,�eGc MICHELLE J. DE N c'0 °�g, MICWEIIE J. b
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* Commission # GG 1 3 E. * I) Commission # GG 1
Commission No.f���J05J�� ) immission No.(76S�S a Expires October 22,
N� c� Expires October 22, 2021
91 FF� BoodedrbatBudgetNotary erviceii 9FOF o��c BondedTtuaBudgetNotary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/20
Rev. 5/b/20