HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
O r
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial yes Residential NO
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578
PERMITAPPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: FPL 6601 S. Ocean Drive Jensen Beach FL Parking lot, Gate B ( Training Building )
Property Tax ID#: JSOg"- I fI -oorj). C)Q6 �i Lot No,
Site Plan Name: Block No.
Project Name: Electric Vehicle Charging Station, Gate B ( Training Building )
DETAILED DESCRIPTION OF WORK:
Installation of two ( 2 ) EV Chargers. (4ports)
Installation of Two ( 2 ) 240v breaker at two pole 40amp.32amp Power Share
each
Replace rusted outdoor Panel, Power to arrive from existing 400amp 120/240v
New Electrical Meter NA Second Electrical Meter NA
CONSTRUCTION INFORMATION:
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 NA Pitch
Total Sq. Ft of Construction: NA Sq, Ft. of First Floor: NA
Cost of Construction: $ 18,000 Utilities: _ Sewer _ Septic Building Height: NA
OWNER/LESSEE:
CONTRACTOR:
Name 6mic r
Name:Carlos A. De Jesus
Address; V r�t: O
Company: ELECTRIC AVENUE Inc,
/�/1
City:S 1�/n_j !')rau, State:
Address: 11621 SW22ct
Zip Code: O P Fax:
City: Davie State: FL
Phone No. % ? - '7 '
Zip Code: 33325 Fax:
E-Mail: ems{ , tUt J(zrS P��(_ rr,
Phone Nos6aaa6aloe
Fill in fee simple Title Holder on next page ( if different
E-Mail electrician@yourservicefast.com
from the Owner listed above)
State or County License EC13001809
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
Name:
MORTGAGE COMPANY: ✓Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
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 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 lender or an attornev before commencing work or recording vour Notice of Commencement.
Win
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License der
STATE OF FLO A STATE OF FLORID
COUNTYOF Mm iaeaj COUNTY OF �O '-) RP-q?
Swoph
to (or affirmed) and subscribed before me of
Ph sical Presence or _Online Notarization
this�ayof�tA.:J..��2020 by
Name of person making statement.
Personally Known � OR Produced Identification
Type of Identification
Notary
Commission No.
KAHMANN
ate of Florio
GG 360550
S oPto (or affirmed) and subscribed before me of
this�r h sisal Presence or Online Notarization
dayof_ 2020 by
A D6� S
Name of person making statement.
Personally Knowll OR Produced Identification
Tvoe of identification i1
of
No.
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SREVIEWOR
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COUNTER
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DATE
COMPLETED