HomeMy WebLinkAboutBuilding Permit ApplicationBuilding Permit Application � S .
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/16/2020 Permit Number: No 12--,
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Building Permit Application �`(/c70 v, 1O
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
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Address: 6603 Donlon Road Fort Pierce,FL 34951
. 1301-613-0017-000-1 17
Property Tax ID#. Lot No.
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Site Plan Name: Block No. 137
Project Name: Richardson Residence
D_ET� LED DECRfPT10N OF U1tORK _
Relocate existing electrical panel from bathroom to another room in the house.
New Electrical Meter Second Electrical Meter
CONSTRUCTININFO( .IUMPTION =
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
,z Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 1800.00 Utilities: —Sewer _Septic Building Height:
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NameShareka D. Richardson Name:Michael Pride
Address:6603 Donlon Road Company:Pride Electrical Services of FL Inc,
City: Fort Pierce State:_ Address:843 S. Kings Highway
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34983 Fax: 772-461-2778
E-Mail: Phone No 772-461-2777
Fill in fee simple Title Holder on next page(if different E-Mail mike@pride-electrical.com
from the Owner listed above) State or County License EC13005859
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.
St3PP�.EIVIENT�AL�CgNSTR�JCTION L'��N�LAW�IN�ORMAT[OI� ��z: �,y ���� �,, {x f��r�3JN � 4w
DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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 a jobsite before the first inspect' end to to financing, consult
with I er or ore b fore commencing work or recoro-Mg your Notic-eNqKommoncement.
SigrOuffof Owner/L ssee/ ontractor as Agent for Owner sigrhtt6k of Contractor/Li ense o er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF \ COUNTY OF
Swor or affirmed)and subscribed before me of Sworn or affirmed)and subscribed before me of
Physical Pres nce or Online Notarization Physical Pres a or Online Notarization
this day of 2020 by this to day of 2020 by
Name of person making statement. Name of person making statement.
Personally own V Produced Id of ation Personally Known roduced Identif ca on
Type d nti i tion Typ e tiou_
Prod ced P oduce
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
��y David Raymo P e ��y David Raymond Prue
Commission No. ! ARYPU eI> I Commission! RPUBLIC (Seal)
STATE OF FLORIDA a .SS E OF FLORIDA
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REVIEWS FA'Og` E pMMIN/20 3SUPERVISOR PLANS VgWfATIO*pi eSiJ*'J @E MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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