HomeMy WebLinkAboutBUILDING PERMIT APPLICATION F y _
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: January 25, 2021 Permit Number:
LUCCP °R
Building Permit Application s°N".
Planning and Development Services C�°9
Building and Code Regulation Division Commercial Residentlblo
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:Electrical
%PR�7PQSED IyItiPRQVEMET LOCATI( N: y, r ,s `fig
Address: 10410 S. Ocean Drive Jensen Beach, FL 34957 (Unit#903)
Property Tax ID#: 4511-514-0066-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Residence for Rich & Lorrie Mihaljevic
DETAIALED DESCRIPTION OF WORK
Bathroom alteration: Install (3) high hats and outlets (3)switch outlets and replace (1)exhaust fan and outlet
New Electrical Meter Second Electrical Meter
CONSTRUCTtt3N FORM AT
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: $ 525.00 Utilities: —Sewer _Septic Building Height:
;QUIINER/LESSEE f CONT AACTUR: �
Name Rick&Lorrie Mihalijevic Name:Patrick Cristiano
Address:10410 S. Ocean Drive Company:Cristiano Electric, Inc.
City: Jensen Beach State:_ Address:5781 NW 15th Street
Zip Code: 34957 Fax: City: Margate State:FL
Phone No.585-315-9870 Zip Code: 33063 Fax: 954-969-9595
E-Mail:rmihalje@rochester.rr.com Phone No954-968-7477
Fill in fee simple Title Holder on next page( if different E-Mailcriselec@bellsouth.net
from the Owner listed above) State or County License EC0002216
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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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 Reeord•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 attorneybefore.commencingwor ordin o our N ice Commencement.
Signature of Owner/Le see/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OFB—re
Sworn to(or affirmed)_and subscribed before me of Sworn to(or affirmed)and'subscribed before me of
x Physical Presence or Online Notarization x Physical Presence or Online Notarization
.this 27 dray of January � 2024 by this 25 dal of January . 2020 by
Name of person making Ratement. - Name of person making statement. .
Personally Known x, 'OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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'Y PiiB:, KARLA YUGOVICH '
A G Gn
(Signature of No 1 'tewof11bo is)late of Florida (Signature of ar -ubli :�Florldralission k GG 207273
9 a:_ Commission=GG 207273 oFF�` My Comm.Expires Apr.15,2022
OF �' y omm.E/'-Mr Apr 15.2022 —="- onded thr h N lanai Notary Assn.
Commission NO. C?"' rough + W Notary Assn. Commission Nil C cab
REVIEWS_- FRONT ZONING- SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER - REVIEW REVIEW REVIEW', REVIEW' REVIEW REVIEW
DATE .
RECEIVED
DATE
COMPLETED
ev.5/6/20