HomeMy WebLinkAboutGadway Permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR: Gadway -well Circuit
PROPOSED IMPROVEMENT LOCATION
Address: 102 Springhill Dr Jensen Beach 34957
Property Tax ID#:
Site Plan Name:
Project Name: well pump circuit
l DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Add circuit for well pump. Run 10g in S80 conduit from meter main to disconnect on dwelling. From disconnect to pump, in S80 conduit underground.
Stub out at pump location for connection by plumber. 30A breaker in meter main. 10g THHN (x4) in 112" S80 PVC entire run.
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:
Cost of Construction: $ 740
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Michael Gadway
Name: Jeff Chiyka
Address: 102 Springhill Dr
Company: Detail Electrician
City: Jensen Beach State: i
Zip Code: 34957 Fax:
Phone No. 518-569-7233
Address: 1165 Se Preston Ln
City: PSL State: FL
Zip Code: 34983 Fax:
Phone No 772-204-6532
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail service@detailelectrician.com
State or County License ES12001430
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 Nat Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
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
with lender or an attorney before commencing work or recording your Notice of Commencement.
Kev. 5/6/20
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sign re f on ractorf License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF_� (�
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
� Physical Presence or Online Notarization
this day of , 2020 by
thisay of _ 2020 by
1R r�
. _. j �YlXSh 1
Name of person making statement.
Name of person r laking statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Pub[ Flori�IqiIRNNL.EMAHSKI
(Signature of Notary Public- State of Florida)
MY COMMISSION # GG 067641
a".,
Commission No. (Sea])
Commission No. '� E�(g1B ApNI17,2021
Bonded ihni o ry Pubic Underwriters
REVIEWS
FRONT
ZONING;
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 5/6/20