HomeMy WebLinkAboutPermit Package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/21/2020 Permit Number:
9L l�1�QL5
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Electric - New Service
PROPOSED IMPROVEMENT LOCATION:
Address: 2410 S. Brocksmith Road
Property Tax ID#: 2320-501-0010-000-0 Lot No. 10
Site Plan Name: Block No. 1
Project Name: Nandelstadt Residence
j DETAILED DESCRIPTION OF WORK:
Addition for Barn:
Install a 200amp Meter main, with at least(10) circuit capacity, for new underground service. 120-240 volt Single-phase.
FPL will service wire.
New Electrical Meter X 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: $ 1,600.00 Utilities: —Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Stephan C. Nandelstadt Name: Kent Blosser
Address: 11501 SW Rossano Ln. Company: Blosser Electric
City: Port Saint Lucie State:_ Address: P.O Box 7305
Zip Code: 34987 Fax:-- City: Port Saint Lucie State:FL
Phone No. 786-299-9289 Zip Code: 34985 Fax: --
E-Mail: phesen@gmail.com Phone No 772-337-0055
Fill in fee simple Title Holder on next page(if different E-Mail nrblosser@gmail.com
from the Owner listed above) 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.
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, consul-
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 FLORIDA STATE OF FLORIDA
COUNTY OF _ `�l li 1�. COUNTY OF a, L U(LQ
Sw rn to(or affirmed)and subscribed before me of Swyrn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization ✓ Physical Pre ence or Online Notarization
this&�J-day of_kQL1 2020 by this day of 2020 by
fty N n;_fJ�f T&ler
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
(Signature of Notary Public -fie o�'Flor NHANSON (Signature of Notary Public- atai' 4orida ) ALiSONHANSON
MY COMMISSION#GG 970043 .: MY COMMISSION#GG 97004
Commission No. EXP Ililarch 16,2024 Commission No. =" P (�I�ES:March 16,2024
�� OP Bonded ThN Notary Pubtic Underwriters •••°.°`O'' Bonded Thru Notary Public Underwrlt REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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