HomeMy WebLinkAboutHOFFMAN APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
C� O��; L07
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 4624578
Commercial
Address: 1031 BRADLEY ST FORT PIERCE, FL 34982
Property Tax ID #: 3402-608-0280-000-5
Site Plan Name:
Pro
ject Name:
GENERATOR INSTALLATION
New Electrical Meter
Second Electrical Meter
Permit Number:
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
Gas Tank
_
Plumbing
Total Sq. Ft of Construction:
Gas Piping
_
Sprinklers
Cost of Construction: $
_Shutters
Generator
Residential X
_Windows/Doors
Sq. Ft, of First Floor:
Lot No.24
Block No. 48
_ Pond
Utilities: _Sewer _Septic Building Height:
NameDAVID WAYNE & ELISABETH HANKE HOFFMAN
Address;1031 BRADLEY ST
City: FORT PIERCE
Zip Code: 34982
F
Phone No.772-489-9027
E-Mai I: dhoffman@dwhoffman.com
State:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:GARETT GUIDROZ
Company:COMPLETE ELECTRIC INC
Address:637 SEBASTIAN BLVD
Pitch
City: SEBASTIAN State: FL
Zip Code: 32958 Fax: 772-388-2411
Phone 1\10772-388-0533
E-Mail cregan@completeelectricinc.com
State or County License EC0001911
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:
If
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 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.
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e of Owner/ Lessee/Contractor as Agent for Owner
Signature
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF --Wit..(. .._ ~ ' ; •<,.t V/
COUNTY OF
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Sworrr1,tcr(6r affirmed) and subscribed before me of
sworn o or affirmed) and subscribed before me of
Physical Presence or Online Notarization
hysical Presence or Online Notarization
this " "' day of ; P = 202�5 by
this day of )-26'by
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identificatiorr
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced.
Produced
(Signature of Notary Public- State o `Florida)
(Signature of Notary Public- State of�Floridaqt )
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