HomeMy WebLinkAboutBUSH RESIDENCE PERMIT APPLICATION20200922_11391992All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/21/2020 Permit Nui
91T. LOME
O
p: Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION` i
Address: 11122 Orange Avenue
Property Tax ID #: 2309-133-0004-0000-1
Site Plan Name:
Project Name: Bush Residence
installation of (2) ceiling fan, (1) Vapor Proof LED 4' light, (4) outlets, (3) switches per plan
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
Total Sq. Ft of Construction:
Cost of Construction:$ /SSD UO
Generator
Sq. Ft. of First Floor:
Lot No.
Black No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR: !
NameThomas G. Bush
Name: Michael Pride
Address: 11122 Orange Avenue
Company: Pride Electrical Services of FI Inc.
City: Fort Pierce State: _
Zip Code: 33408 Fax:
Phone No. 561-313-7247
Address: 843 S. King$ Highway
City: Port Pierce State: FL
Zip Code: 34945 772-461-2778
Phone No 772-461-2777
E -Mail:
Fill In fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail mike@pride-electrical.com
State or County License EC1300-5859
If value of construction is 2500 or more, a RtLUKUtu nonce v, �ccj.;.....••
If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required.
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 Counttyv makes no representation that Is granting a permit will authorize the per tt holder to build the subject structure
which is in cordlict with anV applicable Home Owners Association rules, bylaws or and c venants that may restrict or prohibtt such
structure. Please consult with your Home Owners Association and review your deed for ny restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, In, II 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 conwrrenoy review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory ekes to another non-residential use
WARNING TO OWNER: Your fallure to Record a Notice of Commencementy result in paying twke far
Improvements to yo roperty. A Notice of Commencement must b recorded In the public records of St.
Lucie County and p ste on the jobsite before the first Inspection. If you intend tain financing, consult
with Lender or an orn y before commencing work or record yo c f Cencement.
as Agent
STATE OF FLORIDA
COUNTY OF
Svtp4 to (or affirmed) and subscribed before me of
Physical Presence iy Online Notarization
this�t day of -5., 2= by
M iC wo-g(- Ae/ j)is
Name of person making statement.
Personally Known III OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No.
REVIEWS
FRONT "
COUNTER
140TARY PUBLIC
STATE OF FLORIDA
COUNTY 0.
Swo n to (or affirmed) and subscribed before me of
_P 1 Presenice or online Notarization
this day of .- ' 2020 by
A4 ttM#e-�- J' t l b z::
Name of person making statement.
Personally Known t_ OR Produced Identification
Type of Identification
Produce '(
C
(Signature of Notary Public- State of Florida )
DeAnn A. Prue
Commission No, +�NOTA&MBLIC
STATE OF FLORIDA
PLANS I VVIEWO" EWIEREEW REI REVIEW RE W
NEW
DESIGNER ENGINEER:
x Not Applicable
MORTGAGE COMPANY:
X Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zfp: hone:
FEE SIMPLE TITLE HOLDER:
x Not Applicable
BONDING COMPANY:
x Not Applicable
Name:
r
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 Counttyv makes no representation that Is granting a permit will authorize the per tt holder to build the subject structure
which is in cordlict with anV applicable Home Owners Association rules, bylaws or and c venants that may restrict or prohibtt such
structure. Please consult with your Home Owners Association and review your deed for ny restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, In, II 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 conwrrenoy review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory ekes to another non-residential use
WARNING TO OWNER: Your fallure to Record a Notice of Commencementy result in paying twke far
Improvements to yo roperty. A Notice of Commencement must b recorded In the public records of St.
Lucie County and p ste on the jobsite before the first Inspection. If you intend tain financing, consult
with Lender or an orn y before commencing work or record yo c f Cencement.
as Agent
STATE OF FLORIDA
COUNTY OF
Svtp4 to (or affirmed) and subscribed before me of
Physical Presence iy Online Notarization
this�t day of -5., 2= by
M iC wo-g(- Ae/ j)is
Name of person making statement.
Personally Known III OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No.
REVIEWS
FRONT "
COUNTER
140TARY PUBLIC
STATE OF FLORIDA
COUNTY 0.
Swo n to (or affirmed) and subscribed before me of
_P 1 Presenice or online Notarization
this day of .- ' 2020 by
A4 ttM#e-�- J' t l b z::
Name of person making statement.
Personally Known t_ OR Produced Identification
Type of Identification
Produce '(
C
(Signature of Notary Public- State of Florida )
DeAnn A. Prue
Commission No, +�NOTA&MBLIC
STATE OF FLORIDA
PLANS I VVIEWO" EWIEREEW REI REVIEW RE W