HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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: Electrical
PROPOSED IMPROVEMENT LOCATION:
11 Address: 27 LAKE VISTA TRL 204
Property Tax ID ##: 3422-500-0375-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Bring new 30 amp circuit with # 10 THHN for air handler unit
New Electrical Meter no . Second Electrical Meter no
CONSTRUCTION INFORMATION:
Y F
Additional work to be performed under this permit'— check all that apply:
_Mechanical — Gas Tank _ Gas Piping Shutters Windows/Doors _ Pgnd-,
,x,- Electric _ Plumbing ! Sprinklers _ Generator T Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
.a
Cost of Construction: $ c5/0 Utilities:, Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Patria Diaz
Name: Jorge F• Granadillo
Address: 27 LAKE VISTA TRL 204
City: Port St Lucie State: _
Zip Code: 34952 Fax:
Phone No. 772 418-3631
company: Grans Electric A/O & Plumbing, Inc
Address: 3073 SW Ann Arbor Rd
City: Port St Lucie State: FL
Zip Code: 34953 Fax:
Phone No 772 342-9713
E-Mail granadillo69(Lbyahoo.com p
State or County License EC13005395
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
If value of construction is 2500or 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: i Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ No�Appiicable
Name:
Address.
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
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 Commencemdnt 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 attornev-before commencine work or recording vnttr Nntica of (r)mmencPmznt
Signature of Owne s`' ctor as Agent for Owner
Signature of Connr Ider
STATE OF FLORID
COUNTY OF I
STATE OF FLORID
U l.l.`C%
COUNTY OF �� 10 LtU
Swor o {or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence qr Online Notarization
Physical Presence or Online Notarization
this �_ day of —=AL, 2020 by
this LlI day of VR. 2020 by
Name of peAton making sta went.
Name of persdn making statement.
Personally Known _�DR Produced tification
Personally Known f/ OR Produced Ide tification
Type of Identification
Type of Identification
Produced
Produced
AzXC'Al
f/0 .
(Sig ature of Notary Publi
S RESNILLO
Sign re of Notary P
t - e o SNILLO
Commission No. GL
-2 = State of Florida -Notary Publi
*3 r0ea&ion # GG 272747
ommission No.
," .fV
; o �- State of Florida -Notary Public
Commie# GG 272747
P M Commission Expires
FlO\\Y P
Nt Commission Expires
/OF Y P
December 22, 2022
'++++ December 22, 2022
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ev. 5/6/20