HomeMy WebLinkAboutBuilding Permit ApplicationAll 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
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electric
PROPOSED IMPROVEMENT LOCATION:
Address: 688 NETTLES BLVD
Property Tax ID #: 4502-501-0874-000-8
Site Plan Name: 688 Nettles
Project Name: Doscher
DETAILED DESCRIPTION OF WORK:
Remove existing pedestal - install new RV panel and 200 AM meter socket
New Electrical Meter X
Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
Lot No. 688
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 _ Sprinklers _ Generator __- Roof Pitch
Total Sq. Ft of Construction: 372
Cost of Construction: $ 1000
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Richard Doscher
Name: Donald B Green
Address: 821 Pecan St
Company: Don Green Electric
City: Lindenhurst NY State: _
Zip Code. 11757 Fax:
Phone No. 631-455-2241
Address: 1305 W 1 st Street
City: Port Pierce State: EL
Zip Code: 34982 Fax:
Phone No 772-418-5739
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail dongreenelectdc@gmail.00m
State or County License EC13007447
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: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name: _
Name:
Address:
Address:
City: State:
City: _ State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: X 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 FLORIDA (
COUNTY OF�U
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
x P ysical Pre nce or Online Notarization
Sworn to (or affirmed) and subscribed before me of
x sical Presence —or Online Notarization
thi day of 2020 by
this day of 2020 by
Donald 6 Green
Donald B Green
Name of person making statement.
Name of person making statement.
Personally Known X R Pro uced I entification
Type of Identificatio
Personally Known X OR Produced Identificat n
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