HomeMy WebLinkAboutApplication Millenniun Contracting _ Electric CollinAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
� 11
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:ELECTRIC
PROPOSED IMPROVEMENT LOCATION:
Address: 5450 Palmetto AVE Fort Pierce, FL 34982-3322
Property Tax ID #: 3409-502-0001-000-2
Site Plan Name:
Project Name: Collin
DETAILED DESCRIPTION OF WORK:
Install 120V 20AMP Dedicated GFCI Circuit
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 _
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Lot No.213
Block No.
Windows/Doors _ Pond
Roof Pitch
Cost of Construction: $ 700.00 Utilities: —Sewer —Septic Building Height:
OWNER%LESSEE:
CONTRACTOR:
_ _ _
Name Alan S Collin
Name:Anthony Stumpp
Address:5450 Palmetto AVE
Company: Millennium Contracting Services Inc
City: Ft Pierce State:,
Zip Code: 34982 Fax:
Phone No.772-485-6575
Address:9015 SE Hobe Ridgeg Rd
City: hobe Sound State: FL
Zip Code: 33455 Fax:
Phone No561-718-9422
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail mcsielectric@bellsouth.net
State or County License EC13001885
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires.
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 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
wit4 lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of ontractor/Lice a older
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
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STATE OF FLORIDA
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to (or affirmed) and subscribed before me of
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Sworn to (or affirmed) and subscribed before me of
r_/Physical Preseyce or Online Notarization
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1 day of 4eM by -Z ;q �
this y— day of
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Name of person making statement.
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Name of person m i g statement.
Personally Kno n Produced Identification
Personally Kno R Produced Identification
Type of Identification
Type of Ide ication
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(Signatu of ary Pu -: pf FloriCkA*RYN POCKER
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Notary Public - State of Florida
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Commission No. .. My Cofitfh:`ESlpires Nov 21, 2024
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Commission ` MY 9�2rI xPires Nov 2t. 2024
Notary Assn.
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Bonded through Nation -at NotaryAssn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20