HomeMy WebLinkAboutSLC.Permit APP.7009 Carlton Road.All APPLICABLE INFO M115-17 BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Nurnber:
Date.
Building Permit Application
Planning and Development services Residential
Building and Code Regulation Division commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: L4,e L4,c. 6- QTc
PROPOSED IMPROVEMENT LOCATION:
Address: ��'L' 1 �a r �"bn
Property Tax ID i#:
3228-111-0002-000-4 Lot Na.
Site Plan Name:
Sec/Town/Range 28136S138E Block No.
Project Name,
DETAILED DESCRIPTION OF WORK:
rP
Pr
rpv�t�e
a 1r)5 1i
fJ! J
j1 -0e k.r' fZ ;z
New Electrical Meter X 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: $ 1800.00
OWN ER/LESSEE
Name Osco Holdings Inc.
Ar4,4rQCc. 7000 Carlton Road
Windows/Doors Pond
Generator _ Roof
Sq. Ft. of First Floor:
Utilities: _Sewer —Septic Building Height:
City: fort St Lucie State: FL
Zip Code: 34987 Fax:
Phone No. 305 031-7675
P-nn�il - libertyforlife@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
�' CONT
RACTO R:
Name: Joseph E Herndon Sr
Company: Joe's Electric of St Lucie Cnty., Inc.
Address: 1206 Bell Avenue
City: Fort Fierce State: FL
Zip Code: 34982 Fax:
Phone No 772 465-2363
E -Mail joeselecstlucie@aol.com
State or County License EC13007203
Pitch
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: X Not Applicable
MORTGAGE COMPANY: x� Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: x 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 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
with IvAMor an attorney before commencing work or recording our Notice of Commencement.
e of ontracto License Holder
Signature f o er/ Lessee/Contractor as Agent for owner Sig/ATE
STAT OF FLORID OF FLORI
LL4
CO TY OF C� t C.�-t OU Cl Ls-4
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 2;A L11 2020 by this day of _}; r y� 2020 by
ae6 K CS45 h5g'—
Name of pefson making statement. Name making statement.
Personally Known W___�OR Produced Identification Personally Known k OR Produced Identification
Type of Identification Type of Identification
ProducedProduced
AL 2Z Z 4` '
(Signature ogNotary Public- State of Florida) (Signature of Not6y Public- State of Florida }
Commission No. ✓ Nary u�ic)c ofFVxw%b Commission No. Notary Pu ofRxids
Randolph MCDanikH ap Randolph McDaniel
M Commission GG 352355
,..o+
«R Expires 09107 023 or Expires 09107 3
REVIEWS FRC} PLANS VEGETATt` M
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
e v.