HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02-05-2021 Permit Number:
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>� � L E, � to Building Permit Application
Planning and Development Services
Building and Code Regulation Division CofTimeCCia I X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Holiday Out at Saint Lucie
PROPOSED IMPROVEMENT LOCATION:
Address: 10725 S. Ocean Dr.
Property Tax I D #:
Site Plan Name:
Project Name: Holiday Out new sewer lift station
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Install one new 100 amp 120/240 1 ph service and one 60 amp circuit to prebuilt pump station controller.
New Electrical Meter X Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
X Electric _ Plumbing — Sprinklers Generator Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 11,800.00
Sq. Ft. of First Floor:
Utilities: —Sewer `Septic
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name_ r) ^'I J-
Name: Randy Oliveira
Address: \ Q a S' 7� . C-kw� OZ
Company: Go Local Electric LLC
City: -'7nr- r-,6 State: J(_
Zip Cade u-T ) — ] Fax:
Phone No.
Address:660 SE Monterey Rd.
City: Stuart State: FL
Zip Code: 34994 Fax: nla
Phone No772-237-2351
E-Mail: IU r3
_
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail info@golocaI electric. com
State or County License ER13014996
IT Value or construction is LSuu or more, a KtL(JKUrU 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 I Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:—
- Not Applicable I BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 wil I, 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 con currency review: room additions,
accessory structures, swimming pools, fences, wails, 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 thejobsite before the first inspection. If you intend to obtain financing, consult
with lender or an atto rney before co m rn enci ng work or record in our Notice of Commencement.
Sign=or/ Lessee/Contractor as Agent for Owner
Signature ❑ntra or/License Holder
SDA
STATE OF FLORIDA
COUNTY OF ()af-` , C�
COUNTY OFwrtin
SSworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
.]/ Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this ? day of P(C 4b 2020 by
this 05 day of FChruary 2021 , 2020 by
Lip
Name of person making statement.
Name of person making statement.k rY + { t e i nA
AiN
X
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Pro c
I Produced /{
(Signature of Nota
(Signature of Notary Publi
:i*+r DANIELLE ZIELINSKI
Notary Public Susie or Florida
Commission No. : = Commission $W21
Commission No. cGxa�aas MaJtq dens
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Expires October 13, 2023
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