HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/3/20 Permit Number:
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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: Electric
VEMENT LOCATION:
Address: 8256 Sandpine Circle, Port St. Lucie, FL 34952
Property Tax ID ft: 3426-703-0033-000-5 Lot No.19
Site Plan Name: Jurceka Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install 120V for receptor (20 AMP) GFCI protected receptacle Circuit in Master Bathroom
New Electrical Meter Second Electrical Meter
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: $ 700.00 Utilities: —Sewer _Septic Building Height:
NameJohn A Jurceka Name:Walter Nasi
Address:8256 Sandpine CIR Company:Sol Electric LLC
City: Port St Lucie, FL State:_ Address:5500 SW 43rd Ter
Zip Code: 34952 Fax: City: Ft Lauderdale State:FL
Phone No.772-200-1081 Zip Code: 33314 Fax:
E-Mail: Phone N0754-423-4105
Fill in fee simple Title Holder on next page (if different E-Mailwnasi72@yahoo.com
from the Owner listed above) State or County License EC1 3008044
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.
PLEMENTAL' STR
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _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
structure. Pleas consult nwiithpyolurHome Owners Association andrrevlewy bylaws deed for any restrictions which ay or prohibit such
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 attorne before commencin work or recordin our Notice of Commencement.
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Signat of Owneo Lessee/ for as Agent for Owner Signat�Contractor/License Holder
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STATE OF FLORIgA '/� ' ^ STATE OF FLOR19A
COUNTY OF .n_�ijj eU" COUNTY OF fM GtJ'1%�
Swor (or affirmed)and subscribed before me of Swor or affirmed)and subscribed before me of
Physical Presence or_Online Notarization _Physical Presence or—Online Notarization
this day of o 2020 by this,�dayof�l /s 2020 by
'Name of person making statement. Name of person making state ent.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identif n Type of Ident' s
Produ d 14, Produce
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Signature otar of Floc WYN POCKER ( ignature t {I I YN POCKER
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Notary Public-State of Florida ��p,
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Commission No._ �� 4y CommommlViks Nov 21,2024 Commission N :. canmission p HH o1��1�'144'1
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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