HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7-23-20 Permit Number:
O.
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: Electrical
PROPOSED IMPROVEME IT LOC,ATION.
5512 Pinetree Dr
Property Tax ID #: 3402-602-0283-000-8
Site Plan Name: John Edgar
Project Name:
/ORK-=
Re route one one 220 Volt Circuit
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.16 & 17
Block No. 8
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters — Windows/Doors _ Pond
//
�✓ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: —
Cost of Construction: $ 625.00 Utilities: _Sewer _ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJohn Paul Edgar
Address:5512 Pinetree DR
Name: Robert Thompson
Company:R Thompson Electric
City: Fort Pierce State:
Zip Code: 34982 Fax:
Phone No.772-475-8349
Address:439 SE Cork Rd
City: PSL State:FI
Zip Code: 34984 Fax: 772-408-5501
Phone N0772-203-1756
E-Mail:john_edgar@bellsouth.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail rthompsonelectric@yahoo.com
State or County License EC13007306
If value of construction is 2500 or more, a REGOROW Notice oT i-ommencemenz is re4m, cu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMITION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
wit rider or an attgXlKy before commencing work or recording our Notice of mencement.
Signaturb of Owner/ Lessee/Cointractor as Agent for Owner
Signature pf Contractor/License H
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St Lucie
COUNTY OF St Lucie
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this 23 day of July 2020 by
this 23 day of July 2020 by
Robert Thompson
Robert Thompson
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Ide 'fication
Type of Identification
Personally Known x OR Produced Identifica 'on
Type of Identification
Produced
Produced
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tom SSIOn No. GG 302065 =off: )IS L Butterfield
a` mission 302065
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(Signat re of Notary Pu lic- Statri a Notary Public State of FI
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Melissa L Butterfield
Commission No. GG 302065- oJ�a�y Commission GG 302
oa "� res"02114/2023
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
:�e—v.5/6/20