HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
91u
L 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: 2050 Nettles Blvd,Jensen Beach,FI 34957-Nettles Island Inc,a condo-section I Parcel 50 and pro-rat;share in common elements(OR1413-541)
Property Tax ID#: 4502-501-0053-000-7 Lot No. _
Site Plan Name: Johnson Blob No.
Project Name: Johnson
DETAILED DESCRIPTION OF WORK:
Remove existing Pedestal and replace with a Florida approved 125 Amr Pedestal.
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 ._ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft, of First Floor:
Cost of Construction: $2,200.00 Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Charles Johnson Narre:Jar-)es D. Brown
Address:2050 Nettles Blvd. CompanyJim Brown Electric, LLC
City: Jensen Beach, FL State: Address:3352 NE Skyline Drive
Zip Code: 34957 Fax: City: Jensan Beach State:FL
Phone No.772-229-2204 Zip Code: 34957 Fax: Ofc#772-209-0280
E-Mail:6k-) C'L t-1, e ��-� tea , sr, go cam,Ire Phone No Cell#860-803-5333
Fill in fee simple Title Holder on next page(if different E-Mailidb5333@gmail.com
from the Owner listed above)' State or County License County-30871
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 th2t 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 a:cessory uses to another non-residen-ial 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 inspec-ion. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recorcing your Notice of Commencement,
14
ure of Owner/Lessee/ ntractor as Agent for.[]wne 5j,&TOrErre cf Conrrador7License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF i'�o-��- COUNTY OF �r1
Sworn t r affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
hysical Presence or Online Notarization --LA>lTysical Presence or Online Notarization
this r1day of 4 r2s , I ^.2021 by this_g -d 3y of ,- s ,2020 by
V
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Name of person making statement. Name of person making statement.
Personally Known—4,,�R Produced e@t i6n Personally{nown — `Prod cel f-&-nAication
Type of Identification Type of Ide-itificatfon
Produced_J�I ci c-• "e Produced'=l cx c� Lt' •�•��,¢
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Commission NO.cf(a- '� i W ion No.(q C--&J 00 IT (Seal)
;a0.wr! KAREN CODE
MY COMMISSION#GG 981001
:ems: EXPIRES:April 23,2024 := MY CCMMlSS1fl #GG 981001 f `�
REVIEWS FRONT ndep#i N VEGETA N EATI�T'�; rid' 24ROV
COUNTER REVIE "rlik '" JJ Ha4arY Lb1&' ~
DATE
RECEIVED
DATE
COMPLETED
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