HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
G
U L QT T U Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical Service Change
PROPOSED IMPROVEMENT LOCATION:
Address: 5405 Sunset Blvd
Property Tax ID #: 3402-609-0241-000-3 Lot No. 23
Site Plan Name: Block No. 58
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace 200 AMP Panel
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
t�Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ t 0M
Sprinklers _ Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Gerardo & Paola Bautista Garcia
Name: John Cavnar
Address: 5405 Sunset Blvd
Company: Goldstar Electric, Inc.
City: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No.
E-Mail:
Address: 213 NE Sagamore Terrace
City: Port St. Lucie State: FL
Zip Code: 34983 Fax:
Phone No 772-380-5913
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail johnc@goldstar-electric.com
State or County License 23575
It 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: _ Not Applicable
MORTGAGE COMPANY: — Not Applicable
Name:
Name:
Address:
Address:
City: State:
State:
City:
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
Home Owners Association rules, bylaws or and covenants that may restrict orpprohibit such
which is in conflict with any applicable
structure. Please consult with your Home Owners Association and review your deed for any restrictions which mayapply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
Building Codes and St. Lucie County Amendments.
in accordance with the approved plans, the Florida
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
fences, walls, signs, screen rooms and accessory uses to another non-residential use
accessory structures, swimming pools,
Commencement may result in paying twice for
WARNING TO OWNER: Your failure to Record a Notice of
must be recorded in the public records of St.
improvements to your property. A Notice of Commencement
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an a orne before commencing work or recordingour Notice of Commencement.
Si to f ne ssee/Contractor as Agent for Owner Signature of Contractor/License Holder
ATE OF FLORIDA STATE OF FLORIDA
OUNTY OF L��C �� COUNTY OF
Swo edj and subscribed before me of Sworn to (or affirmed) and subscribed before me of
Online Notarization
Physical Prese c or Online Notarization Physical Presence or
this day of 2020 by
�,
this day of l 2020 by
q
Name of person making statement. Name of person making statement.
Personally Know OR Produced Identification Personally Known OR Produced Identification
Type of Identification
en i ica ion
Produced
Produced
ignature of Notary Public- ignature of Notary Public State of Florida )
�I Notary Public State of Florida
R ogautista Garcia mmission No. (Seal)
Commission No. c ►�v co,{,mission HH 063683
11/15/2024
Expires
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