HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
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
PROPOSED IMPROVEMENT LOCATION:
Address: 1096 Nettles Blvd.(St.Lucie County)-Nettles Island Inc.,a condo-section II Parcel 1096 and pro-rata share in common elements
Property Tax ID#: 4502-501-1283-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Gamayo
DETAILED DESCRIPTION OF WORK:
Relocate pedestal, install pvc to existing light post, add 2 outlet locations, pre-run pvc for boat slip.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _ShuttErs _W ndows/Doors Pond
Electric _Plumbing _Sprinklers _GenErator Roof Pitch
Total Sq. Ft of Construction: _ Sq. Ft, of Fist Floor:
Cost of Construction: $ 2,000.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Robert& Helen Gamayo Name:James Brown
Address:7840 NW 170th Ter Company:Jim Brown Electric, LLC
City: Hialeah, FL State: Address:3352 NE Skyline Drive
Zip Code: 33015 Fax: City: Jensen Beach State:FL
Phone No.786-306-0521 Zip Code: 34957 Fax:
E-Mail:robert@southfloridavanlines.com Phone No772-209-0280/F360-803-5333
Fill in fee simple Title Holder on next page(if different E-Mailidb5333@gmail.com
from the Owner listed above) State or County License3ID871 (SLC)
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: _ 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 AmendPnents.
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 lender or an attorney before commencing work or recording our Notice of Commencement.
516 ure of Owner/Lessee/Contractor as Agent for Owner ignature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF W\-a --- -t n COUNTY OF -,,�e...
Sworn to(or.affirmed)and subscribed before me of Sworn ta.(cr affirmed)and subscribed before me of
_,�Physical Presence or Online Notarization "ysical Presence or Online Notarization
this +5 F"day of .—!.2, 2021 by this ' '+"day of �4t,, ,2024 by
Name of person making statement. Name of person making statement.
Personally Known G,--OR Produced Identification Personally Known 'bR Produced Identification
Type of Identification Type of Ide-itification
Produced Produced ;•+o.. i).r , .,cvs' �,�•✓�S[
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(Signature of Notary Public-State of Florida) (Signature of Notary Publlc-State of Florida )
Commission No. G G q 4,I u .. KAREN CODERRE C
SI�lY)COMMISSION#GG9 10Upm ission No.G-C, t it er' (Seal)
EXPIRES:April23,202
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REVIEWS FRONT S VEGETATION 1 ,i VaT0 MWSWORQ 00
COUNTER REVIEW REVIEW REVIEW I REVIEW V W EXPIREI024
DATE i ry ° e rwnl ii
RECEIVED
DATE
COMPLETED
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