HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/27/2020 Permit Number:
s 1 LIB [ _
° 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:
PROPOSED IMPROVEMENT LOCATION:
Address: 6625 Alemendra
Property Tax ID#: 1306-500-0174-000-7 Lot No. 26
Site Plan Name: Block No. 50
Project Name: Bourassa Residence AC
DETAILED DESCRIPTION OF WORK:
Install AC wire to condenser(40 amps).
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 _Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 650.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jeffrey Bourassa Name:Michael Pride
Address:6625 Alemendra Company:Pride Electrical Services of FL
City: Fort Pierce State:_ Address: 843 S. Kings Highway
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No. 603.490-4513 Zip Code: 34945 Fax: 461-2778
E-Mail: Phone No 461-2777 370-6894
Fill in fee simple Title Holder on next page(if different E-Mail mike @ pride-electrical.com
from the Owner listed above) State or County License EC1300-5859 SLC29875
If value of construction is 2S00 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 Oran 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 o e jobsite before the first inspection. If you inten obtain financing, consult
wit pp-1 rnoI4 before commencing work or recording our Notio of Qbmmencement.
SidKaVire of Owner/LesskgXontractor as Agent for Owner n Lure of Contracctor cense Holder
STATE OF FLORID L"` COUNTY OFSTATE OF OR`� r/t Iry COUNTY OF f-1-
Swor�to(or affirmed)and subscribed before me of Swop to(or affirmed)and subscribed before me of
to'or Prese c r_Online Notarization LlPh ical Pre s c Online Notarization
this day of l/ 2020 by this "day of 2020 by
B a o
r a ✓ia� U I�,UZ Y/ a J Cr
Name of person making statement. n N Name of person making statement. LL
y a0c� yr0
Personal) Known OR Produced Identificati ° ersanall Known OR Produced Identification
Type of Identification F ype of Identification pF F—
PrJd +° in rodu ° Z.tti
(Signature of Notary Public-State of Florida) Y (Signature of Notary Public-State of Florida)
I
Commission No. GG as-�,9cA (Seal) Commission No. (VO •� Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/6/20