HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
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: lighting and receptacles
PROPOSED IMPROVEMENT LOCATION:
Address: 122 Queen Catherina Ct Ft Pierce 34949
Property Tax ID #: 1414-701-0136-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Ron Emerson
DETAILED DESCRIPTION OF WORK:
Add (4) 6" wafers on new porch. Install fans/light boxes on porch. Install switch for fan and light and wafer switches
Install a back to back off living room. Add wafers at BBQ and caseta for BBQ wafers
New Electrical Meter Second Electrical Meter
FCONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors Pond
X Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2269 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Ron Emerson
Name: Donald Green
Address:122 Queen Catherina Ct
Company: Don Green Electric
City: Fort Pierce- State: i'.
Address:1305 W 1st St
Zip Code: 34949 Fax:
City: Ft Pierce State:Fl
Phone No.
Zip Code: 34982 Fax:
E-Mail:
Phone N0772-418-5739
Fill in fee simple Title Holder on next page ( if different
E-Mail info@dongreenelectric.com
from the Owner listed above)
State or County License EC1 3007447
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: Applicable
MORTGAGE COMPANY: Not Applicable
SNot
Name:
Name:
Address:
Address:
City: tate:
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
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie G unty and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
withr' n er or an attorney before commencing work or recQf'c)ng your Notice of Commencement.
.1
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF -7S+ LCkC.c_.-
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this Z�S day of t 2020 by
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Lhis ZS clay of J64 1 2021 by
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Y l ✓� 6
Name of person making statement.
Name of person making statement.
Personally Known /, OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of identification
Produced
Produced
(sign tune of Notafry Public- State of A� i a j .Jamie Perna
ignat a of Notary P blic- State of Flo ' Jamie Perna
�i NOTARY PUBLIC
Commission No. o�TATE OF FLORID
Comm# GG267323
NOTARY PUBLIC
Commison No.������Z� STATE OFFLO
Si
Comm# GG2673
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REVIEWS
FRONT
ZONING
SUPERVISOR PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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