HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/5/2020 Permit Number:
LLCLC
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
PERMIT APPLICATION FOR: Electrical
rrcvruSttj.IIV] FKUVEMENT LOCATION:
Address: 167 Camino Del Rio
Property Tax ID #: 3427-111-0002-000-5
Site Plan Name:
Project Name: Harrison Residence
DETAILED DESCRIPTION OF WORK:
Install a 30amp generator inlet and Interlock kit.
New Electrical Meter 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 Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 291.00
OWNER/LESSEE.
Name
Robert Harrison
Sq. Ft. of First Floor:
Residential X
Lot No._
Block No.
Windows/Doors Pond
Roof Pitch
Utilities: _Sewer _ Septic Building Height:
Address: 167 Camino Del Rio
City: Port St. Lucie State: _
Zip Code: 34952 Fax.__
Phone No.772-631-6440
E-Mail: burialbob@comcast.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Kent Blosser
Company: Blosser Electric
Address: P.O Box 7305
! City: Port St. Lucie
Zip Code: 34985 Fax:
Phone No 772-337-0055
E-Mail nrblosser@gmail.com
State or County License EC13001570
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.
State: FL
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION-
DESIGNER/ENGINEER: Not Applicable
Name: MORTGAGE COMPANY: Nat Applicable
Address: Name
City: State: Address:
Zip: Phone City -
Zip:
Zip:. Phone:
FEE SIMPLE TITLE HOLDER: `Not Applicable 80NDING COMPANY:
Name: _Not Applicable
Address: ; Narne:
City: Address:
Zip: Phone: City:
I Z.
Phone:
OWNER/ CONTRACTOR AFFIpIT; 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 Asscciation 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 Bui ding 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 OWNE UR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IM DY ENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED D t�ER�OR
SITE BE RE THE FIRST INSPECTION. IF YOU ND TO OBTAIN FINANCING, CONSULT
WlT1fI Y A RNEY BEFORE RECORDING YOUR OTI D COMME
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY Ol
The forgoing instrument wa acknowledged before me
this day of L 20—Wby
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification —
Produced
I2/7
f
i (Signature of Notar to e
,.,...: 1 HANSON
Commission No. " ?� OYGOMM)� iN#GG970p43
EXPIRE"5 a 16,2024
Bonded Thou Notary Public UrderWM,,s
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE I
RECEIVED [
DATE
COMPLETED
re of Contractor/License Holder
STATE OF FLORIDA
COUNTY OFF It
The forgoing instrument was acknowledged before me
this Cday of 20-Q by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
(Signature of Notary
Commission No.
SUPERVISOR I PLANS VEGETATION
REVIEW J REVIEW l REVIEW
...... fit: WN HANSON
MY COMMISS1 # GG 970043
EXF4R& 16.2024
Bonded Thor Notary Public underwriters
SEA TURTLE I MANGROVE
REVIEW REVIEW