HomeMy WebLinkAboutSLC Permit APP.Steve LaMountain.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3-1A 2021 Permit Number:
0
%° r V Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 10420 Glades Cut Off Rd
K1
Property Tax I D #: 3315-332-0000-000-6 Lot No.
Site Plan Name: Steve & Karen LaMountain Property Block No.
Project Name: Out Building
DETAILED DESCRIPTION OF WORK:
Provide electrical service & wiring to exiting out building
New Electrical Meter X 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 _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5700.00 Utilities: __.. Sewer ` Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Steve & Karen LaMountain
Name: Joseph E: Herndon, Sr.
Address: 4820 State Road 524
Company: Joe's Electric of St Lucie Cnty., Inc.
City: Cocoa State:
Zip Code: Fax:
Phone No.
Address: 1206 Bell Avenue
City: Fort Pierce State: FL
Zip Code: 34982 Fax: NIA
Phone No 772 465-2363
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Joes@usa.com
State or County License EC13007203
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 LAIN INFORMATION-
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: X Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AIFFIDVIT: 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 attorney before commencing work or recording our Notice of Commencement.
_11"�_40' P ,
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Z' 4_'O� d-`_ i
Sign ure of ontractor/License Holder
of O ner/ L see Contractor as Agent for Owner
=STTE
F FLORIDA
STATE OF FLORIDA
COUNTY OF SSLuac
COUNTY OF St Lucie
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this 12 day of March 2020 by
this 12 day of March 2020 by
Joseph F Herndon, Sr
Joseph E Herndon Sr
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known ix OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of k6taryPu
(Signature o otarV Public- State of Florida
Notary Public Stated Florins
Commission No. Randsil McDaniel
R Cdr� ion an 352355
NoterYPublic5tatenPrrI�
McDaniel
GOmmI5510nJ.q,
vxR Expires 08107l2023
My Commission GG 352355
Ex ires 09l0712023
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Rev. 5/6/20