HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/19/2020 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR: ELECTRICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 10851 S OCEAN OR #107
Property Tax ID #: 4511-810-0114-000-0
Site Plan Name:
Project Name. DEBRA JOSEPH
DETAILED DESCRIPTION OF WORK:
INSTALL ELECTRICAL FOR BOATLIFT (SEE 2004-0469)
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical —Gas Tank _Gas Piping —Shutters Windows/Doors Pond
Electric — Plumbing T Sprinklers `Generator ----- Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1200.00
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
Name DEBRA JOSEPH
Address: 10851 S OCEAN DR #107
City: JENSEN BEACH State:F-t_
Zip Code: 34957 Fax:_ _
Phone No. 480-707-2880
E-Mail: DESI•JOSEPH@YAHOO.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: RONALD KINDEL
Company: RK ELECTRIC LLC
Address: 1537 SW LEXINGTON DR
City: FORT ST LUCIE State: FL
Zip Code: 34953 Fax:
Phone No 772-344-9155
E-Mail RKELECTRICFL@GMAIL.COM
State or County License EC13007108
.I va1uv VI %.cnMLIuL:ucJn ib 4auv or more, a KtLUK1JtV Notice or commencement is required.
If value of HAVC is $7,5W or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
Address:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone
_
City: Stater
Zip: - - Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: X Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
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 attorney before commencing work or recording your Notice of Commencement.
Signature of Owner Lessee Contractor as
g / / Agent for Owner
T ^^�
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF t-
STATE OF FLORIDA
COUNTY OF S i . L u (2-, E-
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Phvsical Presence or Online Notarization
Physical Pres ce or Online Notarization
this day of �� jC LA S N_,, 2020 by
this � day of Jl U. S :E 2020 by
L� �-'�� r � E �.
c� rv�•--ram �� r+ D Vic____
Name of person making statement.
_�.O
Name of person making statement. T
Personally Known `` OR Produced Identification
Personally Known ---- OR Produced Identification
Type of Identification
Type of Identification
Produced `
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No(—:<�q 1 qq7!S (Seal)
(Seal)
Commission No. (Seal)
REVIEW
SUPERVISOR
TURTLE
MANGROVE
REVIEW R
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VIEW
REVIEW
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ATE commis
on GG 919975
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res M0612023
RECEIVE 'Expires 10
l2023
DATE
COMPLETED
Rev. 5/6/20