HomeMy WebLinkAboutBuilding Permit Application A
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��
Date: 1/20/21 Permit Number:
111171aa
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
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2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 i
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PERMIT APPLICATION ;FOR:
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PROPOSED IMPROVEMENT LOCATION:
Address: 2945 Bent Pine Dr., Fort Pierce FL 34951
Property Tax ID#: % ( Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Extend conduit and wire approximately 30 feet from rooftop AC condenser unit to grade level location.
Total length of run from electric panel to new condenser is 50 feet.
Install new disconnect switch at new condenser unit.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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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
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ $700.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Karen Russo Name: John Angarola
Address: 2945 Bent Pine Dr. company: Southeast Elect & Maint Corp
City. Fort Pierce, FL State:_ Address: 721 SE Sweetbay Ave
Zip Code: 34951 ; Fax: city: Port St. Lucie State: F
Phone No. 610-331-1182 zip Code: 34983 Fax: 772-879-7898
E-Mail: Russoke@comcast.net Phone No 772-879-7010
Fill in fee simple Title Holder on next page(if different E-Mail seemc96@aol.com
from the Owner listed above) State or County License EC13003327
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicabi e
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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. i
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 len r attorney before commencing work or recor*1 g your 00ce of Commencement.
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Sig—na a of O er/Lessee/Contractor as Agent for Owner Sign a ur of Cont a or/License Holder
ST E OF FLORIDA Q rr STATE OF FLORID
COUNTY OF ` ) l�1 co COUNTY OF UL
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence r Online Notarization Physical Presence or Online Notarization
th s 5 day of�J 2 2t�W by this •ay of 202� by
Name of person making statement. Name of person making stat ent.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification n/ Type of Identificaio �Y
Produc `J l/ Produc 0
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(Si ature Notary Public-StateFlorida (Si ture of ry Public-State of Florida )
��� ELLEN VAUGN
Commissio �Qa da-Nota blic Commi ioR,PPy_ FI I FNI VAUGH�1 Se ')
•= Commission # GG 270079 =o`" e� :State of Florida-Notary Public
ion Expires - Commission # GG 270079
ect ber 221 202 %rF o¢A: My Commission Expires
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REVIEWS `r- uR�f6S' SUPERVISOR PLAN „t � MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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RECEIVED
DATE
COMPLETED
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