HomeMy WebLinkAboutBaiz - 141 NettlesAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2March2021 Permit Number:
LCU:CFE-
L #K, L L Building pp Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical - New Meter
PROPOSED IMPROVEMENT LOCATION:
Address: 141 Nettles Blvd, Jensen Beach, FL 34957
Property Tax ID #: 4502-501-0327-000-9
Residential x
Lot No.
Site Plan Name: Block No.
Project Name: Baiz - 141 Nettles Blvd
DETAILED DESCRIPTION OF WORK:
Remove existing power pedestal, install meter socket, 12/24 3R panel, install new breakers and re -feed home.
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
Total Sq. Ft of Construction:
Cost of Construction: $ 2100.00
Generator
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Enrique Baiz
Name: Donald Green
Address:10800 SW 29th PL
Company: Don Green Electric
City: Davie State: _
Zip Code: 33328 Fax:
Phone No. (305) 803-8170
Address: 1305 W 1 st St
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No (772) 418-5739
E-Mail: esrperformance@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail permits dongreenelectric.com
State or County License EC13007447
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 att rney before commencing work or rec n our Notice f Commencement.
_
Signa ` Lessee/Contiactoras AgerA for Owner
Signatur, ontra r/_Litens--Holder .-- _.... .>
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Sworn 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
thisT6 day of f`-AGiV c 2021 by
this_ day of �IGjVrT 2021 by
Name of person making statement.
Name of person making statement.
Personally Known_ OR Produced Identification
Personally Known i OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- S
LAURIE PHILL
P
re of Notary Public- to
ry
LAURIE PHIL
I
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