HomeMy WebLinkAbout2 Permit App E - JB 504337 - 55166 Fort Pierce Blvd #CATVALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/04/2021
Permit Number:
W10MM
-Amiga -
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BuildingPermit App
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 55166 Fort Pierce Blvd #CATV
Legal Description: right of way NW of
Property Tax I D #: 1301-602-0122-000-6
Site Plan Name: SP - JB 504337 - SLO08B - 55166 Fort Pierce Blvd #CATV
Project Name: Replace - Comcast Power Supply Cabinet
Setbacks Front Back: Right Side: Left Side:
Lot N o .
Block No.
DETAILED DESCRIPTION OF WORK: I
Install new Comcast power supply cabinet on the north side of concrete FPL pole located +/- 25 ft east
of Fort Pierce Blvd, 20 ft south of Sebastian Rd. Remove existing pole mounted cabinet and transfer
meter after final inspection
CONSTRUCTION INFORMATION:
Additional work to e P rformed under this permit — check a apply:
11 HVAC Gas Tank ❑Gas Piping Shutters a Windows/Doors
ZElectric � Plumbing Sprinklers � Generator � Roof Roof pitch
Total Sq. Ft of Construction: 8•25 Sc. Ft. of First Floor:
Cost of Construction: $ $760.08 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Comcast -Anthony Springsteel
Name: Gary J Gifford
Address: 3960 RCA Blvd, Ste 6002
Company: Gary J Gifford, Inc.
City: Palm Beach Gardens State: FL
Address: 350 SW Linden St
Zip Code: 33410 Fax:
City: Stuart State: FL
Phone No.
Zip Code: 34997 Fax: 772'219-0146
E-Mail: anthony.springsteel@comcast.com
Phone No. 772-286-0954
Fill in fee simple Title Holder on next page (if different
E-Mail: 9iffelec@comcast.net
from the Owner listed above)
State or County License: EC13001574
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: x 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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 your Notice of Commencement.
f y,
Signature Con ractor/License Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 4th day of March , 20 21 by
this 4th day of March , 20 21 by
Gary J Gifford
Gary J Gifford
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
SiLA."Ir
gnature of Notary Public- S e or,� a
Notary Public State ofFlorida
ure of Notary t
Notary Public State of Florida
Susan Carrasquiiio
Commission No. HH063255 :, I)My Commission HH 06
Expires 11/12/2024
Carrasquillo
2�Pm VZIMISslon Sion No. HH063255 f HH 063255
Expires 11/12r2024
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REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVI EW
REVIEW
REVIEW
REVIEW
REVIEW
REVI EW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17