HomeMy WebLinkAboutBuilding permit appAR APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Mr. L acUlE -1C.
QVIUMAN
Building Permit Application
Planning and Development services —
Building and Code Regulation Division Commercial id
23W Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-SSS3 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical Connection from Trailer to Service Panel
Address: 7840 Seddlabrook Drive Port St Lucie, FL 34M
Property Tax 10 #: 3321-501-0011.000-3
Site Plan Name:
Project Name: _
Electrical Connection from Trailer to Service
New Electrical Meter V1 Second Electrical Meter
Lot No.11
Block No.
Additional work to be performed under this permit —check all that apply:
t_Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors _ Pond
x/,c2iectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First floor:
Cost of Construction. $
Name23rd Street Enterprises, LLC
Address: 175 SW 7th Street #2410
Utilities: —Sewer _Septic Building Height:
City: Miami State:
Zip Code: 33130 Fax:
Phone No.772-218-8477
E-Mail: usmackl Ohotmall.com
Fig in fee simple Title Holder on next page (H different
from the Owner listed above)
Company:P,�* I�r�
Addressn�S �
City:, 1 ( _State:FL _
Zip Code: 2�� Fax:
Phone No / 2 I
E-Mall,
State or County LIcenw 0 53 )3
If value of construction Is 2500 or more, a RECORDED Notka of Commencement Is required.
H value of HAVC is $7,500 or man, a RECORDED Hotka of Commencement Is required.
DESIGNER ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City: State: _
Zip: Phone
City: State: _
Zip: Phone:
FEE SIMPLE TITLEHOLDER: x 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. Luck County make 9 no representtaation that Is granting a rmlt will authorize the ermit holder to build the subject structure
which Is In conflict with any applicable Home Owners Assoc atlon rulet, bylaws W a� revenants that may, restrict or prohibit such
structure. Please consult with your Homeowners Association and review your ee or any restrictions which may apply.
In consideration of the granting of this requested permit. I do hereby agree that I will, In ail 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 nonresidential 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 jobslte before the first inMeection. If you Intend to obtain financing, consult
STATE OF
COUNTYI
Sworn to (or affirmed) and subscribed before me of
Physical Pre or _ Online Notarization
this day of �'�`^/' q�.2.020 by
Name of person making statement, V
Personally Known OR Produced Identification
Type of Identlficado
Commission No.
NOTARY
Conan# GG367501
STATE OF FLORIDA���v�
COUNTY OF 1 V,
7S to (or affirmed) and subscribed before me of
Physical Presspceor_ Online Notarization
t Is 3p day of , 11 11 t 1 2020 by
Name of person making statement. U
Personally Known ;<? OR Produced Identification
Tvoe of Identification
Commission No.
STATE O�(SF IDA
Comm# GG367501
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