HomeMy WebLinkAboutPermit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/09/2020 Permit Number:
O �
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: Electrical
Address: 7341 Marsh Ter
Property Tax ID#: 3321-804-0028-000-5 Lot No.21
Site Plan Name: Block No.
Project Name: Dalrymple Residence
Install (1)20amp GFI protected circuit on the patio for general use.
Install (2) receptacles and (1)switch control.
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: $ 800 Utilities: _Sewer _Septic Building Height:
Name Glenn Dalrymple Name:Kent Blosser
Address:6 Jayne Dr Company:Blosser Electric
City: Phillipsburg State:_ Address:PO Box 7305
Zip Code: 08865 Fax: City: Port Saint Lucie State:FL
Phone No.610-703-1888 Zip Code: 34985 Fax:
E-Mail:dalrympleglenn75@gmail.com Phone N0772-337-0055
Fill in fee simple Title Holder on next page(if different E-Mailelectricinc.info@gmail.com
from the Owner listed above) State or County License EC13001570
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.
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
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 CountyAIRP posted on the jobsite before the first inspection. u intend to obtain financing, consult
with lendgeorAn attorney before commencing work or recording-0yo9f Notice of Commencement.
Sig ture of O ner/Le see/Contractor as Agent for Owner Sigrlature of Contracto /License Holder
STATE OF FLORJDA STATE OF FLORIDA
COUNTY OF L s COUNTY OFF
Sw n to(or affirmed)and subscribed before me of SwgFn to(or affirmed)and subscribed before me of
sical Presence or Online Notarization gyp/ P sical Presence or Online Notarization
this)P day of 2020 by this F�Iay of�'�P�nn �2020 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
.. ,t ALISON HANSON , ALISON HANSON
MY COMMISSION#GG 9700 +�►
(Signature of Notary - fe oJE9F F&garch 16,2024 (Signature of Notary Pub[ '� F orb �[ �S.March 16,2024
Bonded Thru Notary Public Underwritara + o ,4°P' B4nditl Thru Notary March
,2024 Vera
Commission No. (Sea) Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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