HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/23/2020 Permit Number:
F L O R 1 -Q-A
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 212 Oak Lane, Port Saint Lucie, FL 34952
Property Tax ID#: 3419-501-0100-000-4
Site Plan Name:
Project Name: Markley Residence
DETAILED DESCRIPTION OF WORK:
Replace cloth wiring in the attic only above guest bedroom near attic access.
New Electrical Meter
Second Electrical Meter
Residential X
Lot No.12
Block No. 9
CONSTRUCTION INFORMATION: I
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:
Cost of Construction: $ 1900
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ross Markley
Name: Kent Blosser
Address:212 Oak Ln
Company:Blosser Electric
City: Port Saint Lucie State: _
Zip Code: 34952 Fax:
Phone No.865-356-8996
Address: PO Box 7305
City: Port Saint Lucie State: FL
Zip Code: 34985 Fax:
Phone No772-337-0055
E-Mail: Rossmarkley@hotmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail electricinc.info@gmail.com
State or County License EC13001570
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
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 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
property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and pod on the jobsite before the first inspection. I�ou intend to obtain financing, consult
improvements to yo�®rney,
with lend or an b o ecommencing work or recordin o r Notice of Co encement.
00
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 3+ L( IC'If
COUNTY OF a 14 Ifte
Swo n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this — dray of2020 by
Swo to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
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Name of person making statement.
Name of person making s atement.
/ R Produced Identification
Personally Known •J 0
Personal) Known OR Produced Identification
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Type of Identification
Produced
Type of Identification
Produced 17
(Signature of Notary
Commission No.
M, ALISON HANSON
MY COM >� # GG 970043
=.• .: �
o EXPIRES: March 18, 2024
'•.;;oi '• aided Thru Notary Public Under rIlara
(Signature of Notary
�" ,: ALISON HANSON
Commission No. . :�: MYCOMM(U®4�#GG970043
� Po= EXPIRES: March 16, 2024
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REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5 6/20