HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/22/2020
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Planning and Development Services
Permit Number:
Building Permit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
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PERMIT APPLICATION FOR. Richard Bourbeau
PROPOSED IIt�IPROVEMENT LOCATION.
Address.
S 13827 South River Drive Lake Manor Unit 6 Jensen Beach, FL 34057
Property Tax ID #: 4509-805-0006-000-7
Site Plan Name:
Project Name: return power to Unit 6
DETAILED DESCRIPTION OF WORKS
dig new trench, connect wire to new FPL pole to mobile home
New Electrical Meter X
Second Electrical Meter
Residential X
Lot No. 6
Block No.
CONSTRUCTION INFORMATION..� a--t S `rt'-iC.'. A�i � -te�� ..r•�•... . `Jr. -.•b'a�s'_. �t;.�._:.
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 ounnommmummPitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Richard Bourbeau
Name:
Address:481 Burnett Road
Company:
Ci.ChicopeeMAtyo State:
Address:
Zip Cod e eo01020 Fax:
City* State:
413-246-6800Phone No.Zip
Code: Fax.
BourbeauWelding@yahoo,comE-Mail.Phone
No
Fill in fee (if
_gsimPle Title Holder on next oa e different
E-Mail
from the Owner listed above)
State or County License
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*. X Not Applicable
BONDING COMPANY. Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
I I
Zip: Phone.*---
I
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 Associationand review your deed for any restrictions which may apply.
Inconsideration 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 your Notice of Commencement.
now
Signature of Owne Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
/YldS
STATE OF
STATE OF FLORIDA
COUNTY OF
COUNTY
OF
S rn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Zq Physical Presence or Online Notarization
Physical Presence or Online Notarization
thisd 6 day of Men" Lob 2020 by
this day of 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifica
Type of Identification
Produced /�'1A,
Produced
L'a,
(Sign ure of Notar u d"T Ak - ALA" A(Signature
of Notary Public- State of FloridaCHF1BT'
ONO
Commission No. IF NorftFjublic
Commission No. (Seal)
Commonwealth of Massachusetts
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