HomeMy WebLinkAboutBuilding Permit Package All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/24/2021 Permit Number:
�Ir
® 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: 626 Beach Ave, Port Saint Lucie, FL, 34952
Property Tax ID#: 3419-510-0096-000-0 Lot No.
Site Plan Name: Block No.
Project Name: Deborah Kinsella
[DETAILED DESCRIPTION OF WORK:
Supplying power to shed from exsisting panel with 20 amp 120 volt circuit using#12 THHN and installing 2 GFCI receptacles.
New Electrical Meter Second Electrical Meter
LCOPNSTRUCTION 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 _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1,130 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Deborah Kinsella Name: Anthony Diodato
Address: 626 Beach Ave Company: Stott Brothers Electric
City: Port Saint Lucie, FL State:_ Address: 385 NE Glentry Ave
Zip Code: 34952 Fax: City: Port Saint Lucie State: FL
Phone No. (307)421-4815 p 34983
Zip Code: Fax:
E-Mail: Phone No 772-408-4911
Fill in fee simple Title Holder on next page(if different E-Mail stottbrotherselectric@gmail.com
from the Owner listed above) State or County License EC 13007910
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.
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DESIGNERAENGINEER: 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,attorneybefore commencing work orrecordinRyour,14oti ommencement.
JL
Signa ure of Owner/ rac or as Agent for Owner Signature of Contra r/ ' se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF f
Sworn to{or affirmed}and subscribed before me of Sw,arn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this L2�11day of L- 2020 by this�day of_ -L 2020 by
Name of person maki g statement. Name of person making s a�t ent.
Personally Known OR Produced identification Personally Known OR Produced Identification X
Type of identifica%an Type of identificat"
Produced t 1_ � )J, Produced ��y `�
{Signature of Notary Pu (Sm
nature of Notary Public-Sta
►!Y"? ,: SAVANNASTILLWELL �: SAVANNASTILLWE
Commission No. +i MY9SSM#GG 197659 mission No. �{�OMMISSION#GG 1 7 9
S:March 19,2412 �^�' � •�///J/ ", �o�• EXPIRES:March 19,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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