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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 12/17/2020 Permit Number: 1 rr V 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:Temporary Powell' Pole 1 Electrical PROPOSED IMPROVEMENT LOCATION: Address: 3432 Southern Pines Blvd., Fort Pierce, FL 34982 Property Tax ID#: 2428-702-0065-000-8 Lot No. 24 Site Plan Name: Block No. 3 Project Name: DETAILED DESCRIPTION OF WORK: Supply and Install a temporary power pole to be used while house is being work on due to fire damage 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 YElectric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: G Cost of Construction:$ 6a 0 _ Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Richard Dennis Name:Robert Lynch Address:3432 Southern Pines Blvd Company:Third Day Electric LLC City: Fort Pierce State:_ Address:2057 SE Mary Terrace Zip Code: 34982 Fax: City: Port St Lucie State: FL Phone No. Zip Code: 34962 Fax: E-Mail: Phone No 772-332-4776 Fill in fee simple Title Holder on next page(if different E-Mail thirddayeiectricllc@gmail_com from the Owner listed above) State or County License EC13001947 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: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _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. I n 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 our Notice of Commencement. �f Signatu a of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/L tense Holder STATE OF FLORIDA STATE OF FLORIDAS} C Q_ COUNTY OF S� - L(A c r -� COUNTY OF Sw rn to(or affirmed)and subscribed before me of S rn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization this I-7� day of e-be,/ 2020 by this 1?f~day of `7ec-e r•s 1b e r .2020 by 1�© e-( c beri- L ncv) Name of person making statem nt. Name of person making statement. Personally Known X OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced 1 (SignanVe of Notary Pub ic-St e a any ginkley (Sig ture of Not y Public-Stat My Commission GG 0 �y+ �,pY+�``�"►y�,, N��y pubiic State of For a Commission No.� O gr4 oFadi(SePafpires 0812212©2S o ission No.(11 D &TS0 1 (5e B�nkleyommission GG fora ' Expires 0812212023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. Planning and Development Services Building and Code Regulations O 2300 Virginia Avenue Fort Pierce,FL 34983 772-462-1553 Pax 772-462-6443 �e� ©In7er Fol Q TEMPORARY EARLY POWER RELEASE (Name of Tenant or Owner) The Tenant or Owner requests St/Lucie County Development Seryices Department to release the electrical power at 3 7y� �/lJ A�('(address, including suite number, as posted on the electric meter and the building) for building permit # Q0 11 -G&S�{, for the purpose of construction and testing building systems, including air conditioning, refrigeration, lighting,power and control circuits with the following stipulations: 1. Incomplete or untested circuits are NOT to be energized without properly licensed electrical personnel on the jobsite and no systems are to remain energized beyond the testing/temporary purpose without proper inspection by the St Lucie County Building Department appropriately licensed person(s). 2.All panels and disconnects not in use must he locked in the"OFF"position or fuses removed. 3.Proper procedures for lockout/tagout must be in place. 4.The electrical equipment mom(where applicable)will remain locked at all times with the key in the possession of the electrical contractor. 5. All final inspections relative to the closeout of this project must be requested and passed in a timely manner as determined by the Electrical Inspector and/or the Building Official. 6.The building may not be occupied before a Certificate of Occupancy(C.O.)is issued. 7.No stocking of materials,other than those required for construction is permitted by this agreement 8.No on-site occupancy or training of personnel employed by the occupant,business entity or owner is permitted by this agreement 9.No furniture,racks,furnishings or other personal or corporate property is permitted on site by this agreement. 10. Construction power remains covered by the requirements for GFCI protection and all other requirements of the governing Codes,see National Electrical Code(NEC)Article 590. Violation of this agreement may result in the immediate termination of the electrical power without prior notice or warning to the affected parties. This form requires all of the following signatures prior to power being released.The undersigned acknowledge that the operation of air conditioning equipment while construction is in progress may create or increase the risk of contamination or premature failure of the equipment. The undersigned acknowledges the above listed stipulations, agrees to the terms of this agreement and agrees to hold St Lucie County harmless from any damages that may arise as a result of the release of power to the premises. The undersigned hereby requests power to be released for this project. This form does not guarantee power,which is at the discretion and control of the electrical utility. 1 0 L,r , Important: The occupant of the property (or other appropriate party) shall have made proper application to the electric utility, paid any applicable fees or deposits, and requested power in a timely and informed manner. St Lucie County is not responsible for any delays in the receipt of electric power. We acknowledge and accept the terms of this permission. We further acknowledge that violation of this agreement or a finding of unsafe conditions and/or practices found on the site or occupancy of the site may result in immediate disconnection of this temporary power without warning and hereby release St Lucie County and all representatives of any and all liability resulting from us not abiding with this agreement. Print Name-El 'cal Contractor Company Name F- 171171 � Si atu e-Electrical Contra for Date Signature-Owner Date 44� Print Name-Electrical Vn&actor Print Name-Owner Phone Number-Electrical Contractor Phone Number-Owne� G /30O/ 90 License#Electrical Contractor / 1;�(f 7�70 Si ature-P ' ontractor Date Print Name-Prime Contractor Company Name " 33 -. Z 76-, Print Name-Prune Contractor Phone Number-Prime Contractor License#Prime Contractor Approved for St.Lucie County by: I I Signature-Electrical InspectorlBO lnsp ID# Date Inspector comments,limitations and restrictions: 2 3 y3a Sour he[A Pineggw- E' 79 If f p f E � t } � C i t k