HomeMy WebLinkAboutBuildingPermitApplication-Pineview-Lot33All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
9M:. LUC FES
E7 A z
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: ELECTRICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 3265 US HIGHWAY 1 FT PIERCE (LOT 33)
Property Tax ID #: 2427-601-0054-000-5
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
UPGRADE SERVICE PEDESTAL AND PANEL TO PLUG-IN HOME
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
x Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1490.00
Generator
Sq. Ft. of First Floor:
Residential X
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name PINE VIEW MHP C/O RIVERSTONE COMMUNITIES
Name: JEFFREY R WAITE
Address: 6400 TELEGRAPH RD SUITE 2000
City: BLOOMFIELD TOWNSHIP State: MI
Zip Code: 48301 Fax:
Phone No. 772-293-0069
Company: INFINITY ELECTRIC CO INC
Address: 630 TALL PINES RD
City: HAVERHILL State. FL
Zip Code: 33415 Fax: 561-588-3805
Phone No 561-662-9299
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail INFINITYELECTRIC@BELLSOUTH.NET
State or County License EC 13005456
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
Name:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
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 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
wltn lenaer or an attorney aetore commencing worK or recording your Notice of commencement.
Sig o ner/ Liifssee'Iiffontractor as Agent for Owner
S ATE OF FLORID �j
COUNTY OF Ae.0"' y'y
Swop to (or affirmed) and subscribed before me of
Ph kcal Pres c o Online Notarization
thi day of e�rs r 2020 by
Name of persA makinjstatement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced ., A
(Signature of Nary Public- State of Florida )
State of F o"d luSTICE
REVIE ZL"i FRONTA
DATE
RECEIVED
A
S' 'Afure QfContrdtfor/License Holder
TATE OF FLORID
COUNTY OF
n to (or affirmed) and subscribed before me of
Swo
PVA11 al Pre en r Online Notarization
thisjZ day of 2020 by
Name of p rson mAking statement.
Personally Known V/ OR Produced Identification
Type of Identification
Produced i D
(Signature of Not44 Public- State of Florida )
PERVISOR I PLANS
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KEVIN .IUSTICpeali
tate of Florida -Notary Public
commission # GG
MY LOrOrnission EXDirAc
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