HomeMy WebLinkAboutElec App. All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
os
a ti -� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 10680 S Ocean DR Jensen Beach 34957 Common Area
Property Tax ID#: : 4511-516-0000-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Island Crest Condo- NCI
DETAILED DESCRIPTION OF WORK:
Direct replacement of disconnects, load side conduit, light fixtures, receptacles.
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 _ _Windows/Doors ,Pond
Electric _Plumbing Sprinklers r Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 18, 510.0 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Ownership Island Crest Condominium Association Inc Name:Gregory Greseth
Address: 10680 8 Ocean DR Company:Nichols Contracting Inc
City: Jensen Beach _ State:FL Address:508 Olney Sandy Spring Rd. Ste. 200
Zip Code: 34957 Fax: City: Sandy Spring - State:FL
Phone No. _?7 Z-?_',!� .ZW q -7 Zip Code: 20860 Fax: 561-812-2862
r
E-Mail:Llsr sin S r 6 mal 1 Ca m- Phone No 301-529-8041
Fill in fee simple Title Holder on next page(if different E-Mail msaavedra@nichotscontracting.com
from the Owner listed above) State or County License EC13009689
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 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 attorne before comm work or recording our Notice of Commencement.
5 wnrIDA
ssee/Contractor as Agent for Owner Signature of Contr or/License H er
STATE OF FLO STATE OF FLORIDA
COUNTY OFSi: COUNTY OF Palm seaah
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5woq to(or affirmed) and subscribed before m N sworn to(or affirmed)and subscribed before me of K n
✓Physical Presence or Online Notariz X Physical Presence or Online Notarization 3
this -day of P2br 202 by i il this so day of oecemner 2020 by o 0 �
c3T
G Gregory Greseth
Name of person making statement. ;. _ Name of person making statement. J
NM3:0
Personally Known OR Produced Identific tgg-` Personally Known x OR Produced identification
Type of Identification Type of identification y A
Produced _ Produced
(Signature of Notary Public-State of Florida ) (Signature of Nota ic-State of Florida )
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev, 5/6/20