HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/22/2020' Permit Number:
`v1ro LUCE RECEIVED
o DEC 2 2 2020
AP
Q Building Permit Application p
Permitting Department
Planning and Development Services St. Lucie county
Building and Code Regulation Division Commercial Residential xx
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:14ichOlaS•Sansone .
PROPOSED IMPROVEMENT LOCATION:
Address: 12201 Williams Ryd..,Fort Pierce,
DFL.34987
Property Tax ID#: y� 't.`Z`� 7 ID O b0 Lot No.
Site Plan Name: Sansone Block No.
Project Name: Sansone
DETAILED DESCRIPTION OF WORK:
Replace meter socket bust,one-meter jaw burnt.Note:all electrical wiring Remains the Same change-meter socket only.
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: Sq.Ft,of First Floor:
Cost of Construction:$ 500 Utilities: —Sewer _Septic .Building Height:
OWNER/LESSEE: CONTRACTOR:
Namejicholas Sansone Name:Jackie Flanagan
Address:12201 Williams Rd.,Fort Pierce, FL.:34987 Company-Crest Electric inc.
City: Fort Pierce State: Address:5234 NW Reba Cir.
Zip Code: 34987 Fax: City: Port'St. Lucie State:FL
Phone No. Zip Code: 34986 fax:
E-Mail: Phone No954-520-2748
Fill in fee simple Title Holder on next page(if different E-Mail crestelectricinc@att.net
from the Owner listed above) State or County License EC13004199
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: XK Not Applicable MORTGAGE COMPANY: Xx Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: XK 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 County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attor 'before commencing work or recordingyouf Notice of mencement.
Sign a of wne Lessee Co ctor as Agent for Owner Si ure Contractor/License Hol r
ATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6
..1,..�_X ��� COUNTY OF � T . L )C �F_
SwoXn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
./ Physical Presence or Online Notarization Ph sical Pres ce or Online Notarization
this � �
day of � 2020 by thi day of 2020 by
Name of person making statement; / Name of person making statement. /
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification I✓
Type of IdentifcaUcn Type of Ident' ti n
Produced 1. Produced >
Alt
(Signature of Notary Public-State of Florida), (Signature o
awu, `��Pevv�Bp K EN
Commission No. o�PRYP�a,,, KAREf�S_,NIELSEN .=o _State of Florid,
Commission Public
to of FI Notary Public Commission _. .= ission # GC{ �1�84
*� Commission # GG 207484 p My Commission Expires
M Commission Expires ��'%%n;;��`� June 12, 2022
June 12, 2022
REVIEWS FK -qm" R PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW - REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.