HomeMy WebLinkAboutPermit package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
91r°
4O
0^t M�' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
PropertyTaxlD#: Zt161;S''l6\ - 08')5 - 06A - L11 Lot No.
Site Plan Name: Block No.
Project Name: C`( tk� tCZI6n(!Ate
DETAILED DESCRIPTION OF WORK:
R 1n r, t i ) C-e' mL-n-� hNc�
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 _Windows/Doors _Pond
_Electric �/Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 0 0 0. 00 Utilities: -Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ''r8r,r-1 Name: Unit£_I. Sk NAArN--, fu A
Address: $65 CA,x Company:
City: yr . PS a State:JL, Address: ob\gS ZSrJ16-" Q d
Zip Code: Fax: City: V"� . P I K(-E — State.171-
.
Phone No. Zip Code: 3i I`ihS Fax:
E-Mail: Phone No Y)2-
Fill in fee simple Title Holder on next page ( if different E-Mail n lA 1n, s
from the Owner listed above) State or County License 2-
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 MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _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 lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOI�IpA STATE OF FLORIDA
COUNTY OF a . uk['k P. COUNTY OF ' . �,uCtE
Sworn to(or affirmed) and subscribed before me of Swop to(or affirmed) and subscribed before me of
Physical Presence or_Online Notarization V Physical Presence or Online Notarization
this 2-\ day of ,2020 by this 2t day of QvM ,&* , 2020 by
LJ Vt A P C (� Wv�-A F
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
vsx Notary Public State of FkwWa
M1F (p' 0qri�es�Loonve 0 ublie State of Flmda
(Signature of Notary P oil a^ ° wire' 's 2171TB/2o23 Uy
(Signature of Notary u� �� r oyGG 355843
�' Expires 07/16/2023
Commission NOGG Sea Commission No. G
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20
Fort Pierce Utilities Authority Please remit payment to:
"Committed To Quality" Fort Pierce Utilities Authority ���
WaterlWastewater Engineering Attention:Key Accounts Department
P.O.Box 3191
P.O. Box 3191 (34948-3191) Fort Pierce,FL 34948-3191
1701 S.37th Street
Fort Pierce, FL 34947
Phone(772)466-1600 Fax(7721468-2.414
Job Location: 805 Cory Campbell Road Invoice Number: 5,674
Account Name: Tom McFrederick PCN: 340370100750004
Contact Name: Tom McFrederick FEt#
Billing Address: 805 Cory Campbell Road Fort Pierce FL 34982
Phone: (7721216-15 1 Fax:( } - Cell: Location Id:
Accounting Codes # size Description Fees
06-3-060-43701-0000 1 518 x 314 Water Meter and/or Service Installation General $2.770,34
06-2-000-23500-0000 Water Security Deposit $60.00
O Inside CityLimits
06-3-06OA8800.0000 Water New Account Setup Charge $20,00
06-3-06OA3702-0000 Water Capital Improvement Charge W ERC's 1.00 $1,850.00
08-2-000-23500-0000 Wastewater Security Deposit $0.00
08-3-08048800-0000 Wastewater New Account Setup Charge $0.00
08-3.08043702-0000 Wastewater Capital Improvement Charge WW ERC's 0.00 $0,00
Accounting Codes Construction Cost Estimate Fees
METER AUTHORIZATION NOT REQUIRED
Invoice Total:$4,700.34
Description for service order: Install(1)518"meter and 2"service,see attached cost breakdown.
Annexation Agreement required.
Total Paid: Date Paid: Check Number:
Customers will be assessed wastewater charges the day they connect to the wastewater system or within 361,days from date wastewater Connection
Charge is paid•whichever is first The cos:of the servr_c One from Me point of delivery at the pronerly line to the houserblLldmg is the responsibility of the
customer and a not mcluded in this mymw State laws require that a permit from the Health❑epanment must be obtaned Mt Iq roil el no a score lank_
d¢ynndpn,rim at Contact the Health Department at(772)8734231
Construction cost estimates are based on current labor,equip:rmnt and material prices Actual costs of ceostruction wO be determined at the completion of
the project should unforeseen circumstances be encountered during construction,including but not limited to admrao weather cerglbons and
construction conflicts.the customer will be responsible for increased oasts Addlucnal costs amured by the customer shall not exceed fifteen(15)
percent of the total estimated can^structan costs shvrm above Estimated costs past by the customer Mat exceed the actual cost of construction will be
refunded by Fort Plefce Utilities Authority
-1
Reviewed By: Shane Ostrander,Engineer Trainee Date: 2020-05-14
Customer's Signature: Date:
Printed Name:
FORT PIERCE UTILTIES AUTHORITY Est male vs Actual
WATER DISTRIBUTION
Name: IMR.TOMMcFREDRICK Address:805 CORY CAMPBELL RD
Purpose: lEstimate Request for 2"Water Service and Meter Insallation
,Comments:
Existin Meter Number New Meter#Qf a licable
DATE POSITION RATE HOURS OVERHEAD OVERHEAD TOTAL
PREP'D COMPLTO EST ACT EST ACT ES'i I ACT EST ACT EST ACT
10/01119 00100/00 11 $17.43 1.co_ 51.26% $15.87 51.26% S15.87 42.23 0.00
10101119 00100100 51.26% $15.87 51.26% $16.87 0.00 0.00
10/01119 00/00/00 51.26% S15.87 51.26% S15.87 0.00 0.00
10101119 00/00/00 51.26% $15.87 51.26% S15.87 0.00 0.00
10/01/19 00100/00 51.26% $15.87 51.26% S15.87 0.00 0.00
10101/19 00/0DI00 51,26% $15.87 61.26% $15.87 0.00 0.00
10101/19 00/00100 51.26°k 515.87 51.26% $15.87 0.D0 0.00
10/01/19 00/00/00 51.26% $15.47 151.26% $15.87 000 0.00
10/01/19 00100100 r 51.26% $15.97 51.26% $15.87 0.00 0.00
10/01119 OOft1D100 51.26% $15.87 5126% S15.87 0.00 0.00
TOTALS 42.24 0.00
DATE MATERIALS COST QUANTITY WH MATERIAL DESCR. TOTAL
PREP'O COMPLT'D EST. ACT EST. ACT EST ACT OH EST. ACT
70101/19 01010 VJAM3262 $102.73 1.00 10% - METER PO 578 X 3/4 113.00 0.00
10/01/19 010/0 WAB1709 $21.33 1.00 10% BACKFLOW PREV 314 23.46 0.00
10/01/19 0/0/0 WAN1937 $1-38 2.00 10% NIPPLE BRASS 3/4 3.04 0.00
10/01/19 01010 WAS2055 $6.94 1.00 10% SPUD METER 7.63 0.00
10/01/19 01010 WAM1906 $33.97 1.00 10% METER BOX 37.37 0.00
10/01/19 0/010 WAW2138 $0,14 2.00 10% WASHER,314 0.31 0.00
10/01/19 01010 WAL3285 S34.20 1.00 10% LID FOR METER BOX 37.62 0.00
10/01/19 1 010/0 WAC1825 S52.60 1.00 10% CURB STOP 57.86 0.00
10/01/19 0/010 WAB1745 $11.51 1.00 1 10% BUSHING 2X1 12.66 0.00
10/01119 0f0/0 WAA1695 1 $12.60 1.00 10% ADAPTER,1"MIP 13.86 0.00
10101/19 010/0 WAP1975 $0.36 2.00 10% 1"POLY 2Ft 0.79 0.00
10/01/19 01010 WA11899 $1.08 2.00 10% 1"SS INSERTS 2.38 0.00
10/01119 000 10% 0.00 0.00
10/01/19 0/010 10% 0.00 0.00
10/01/19 01010 10% 0.00 0.00
10/01119 01010 10% 0.00 0.00
10/01/19 0/0/0 10% 0.00 0.00
10/01119 1 01010 10% 0.00 0.00
10/01/19 0/010 10% 0.00 0.00
10/01/19 0/010 10% 0.00 0.00
10l01f19 0!0!0 10% 0.00 0.00
10/01/19 0/010 10°k 0.00 0.00
TOTALS 309.98 0.00
DATE VEHICLESIEQUIP#'S RATE #HRS DESCRIPTION TOTAL
PREP'D COMPLTD EST. ACT EST. ACT EST. ACT EST. ACT
10/01/19 010/0 $4,05 50.00 BAHIA SOD $202.50 $0.00
10/01/19 0/0/0 2198.67 1.00 2-LONG SIDE SERVICE $2198.67 $0.00
10/01/19 0/010 $16.95 1.00 8X2 SADDLE ADJUSTMENT S16.9b $0.00
10/01/19 0/010 SO.00 0.00
10/01119 0/010 SO.00 $0.00
10/01119 0/0/0 SO.00 $0.00
10/01/19 010/0 SO.00 $0.00
10101/19 010/0 SO-00 0.00
10/01/19 0/010 - " SO.00 0.00
10/01119 01010 SO.00 $0.00
TOTALS 2,418.12 $0.00
RECAP - TOTAL
LABOR 42.24 0.00
MATERIALS 309.98 0.00
11,
EQUIPMENT 2418-12 $0.00
1 _ __ GRAND TOTALS 2,770-341 0.00
FY 2020 OVERHEAD RATES:Updated 10/02f19
LABOR OVERHEAD RATE/FRINGE BENEFITS(%OF GROSS WAGES) 51.261X'
GENERAL OVERHEAD RATE(PER HOUR) $15.87
MATERIALS MANAGEMENT %OF VALUE OF INVENTORY 10.00%
Page 1 P12020JOBS12020049"305 Cory Campbn Road)lEVimate 805 Cory Campbell Re
9120.''2020 Maul-"I'om McFredcrick-Outlook
Water Connection - 805 Cory Campbell Rd
Customer Service <cs@fpua.com>
Tue 611612020 1 0:50 AM
To: bbpumps@hotmail.com <bbpumps@hotmail.com>
Good morning Mr. McFrederick,
Thank you for submitting payment for invoice#5,674.
To update your account, please forward a copy of your ID toL.�_@fpua,cor;1 referencing the address in the subject
line to my attention.
Thank you,
Chontae Johnson
Customer Service Representative III
Fort Pierce Utilities Authority
(772) 466-1600 Ext. 3011
Please note.Flonda has a very broad public records law.Most written communications to or from Fort Pierce Utilities Authority employees regarding
government business are public records,available io the public and media upon request.Your e-mail communications may be subject io public
disclosure.
(For additional information.go to hops:ttvmw.(pua.comrinformatiorvPnvacylnformationaspx I
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