HomeMy WebLinkAboutElectrical Permit - S&W Electric for 10921 Orange Ave Ext_000517All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/12/2021
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Permit Number:
Building 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
PROPOSED IMPROVEMENT LOCATION:
Address: 10921 ORANGE AV EXT
Property Tax ID #: 2309-421-0000-000-7
Site Plan Name: 09/35S/39E
Project Name:
DETAILED DESCRIPTION OF WORK:
Repair and rebuild existing service for mobile 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: $ 750.00
Generator
Sq. Ft. of First Floor:
Residential X
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Vera G Tolson (TR)
Name: Daniel Stubbs
Address:2754 Six & Twenty Rd
Company:S&W Electric, Inc
City: Pendleton State: $G
Zip Code: 29670 Fax:
Phone No.
Address:501 W Coker Road
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No 772-464-6466
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail stuboutelectric@aol.com
State or County License EC13007544
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:
Address:
City:
Zip: Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
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 attorney before commencing work or recording vour Notice of Commencement.
Signature of 0 ner essee/Contractor as Agent for Owner
Signature of Con actor/License Holder
STATE OF FLQ kD
STATEFLORIDA
COUNTY OF� Lt_.`o
COUNTYOF f. (( !�
Sworn to (or affirmed) and subscribed before me of
I Swojr to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
I ✓ Physical Presence or Online Notarization
i
this '� day of rya �= 202t1 by
this �� day of n% 202� by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
j Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Pro uced
` Produced
L n
(Signature of Notary Public- Stat
ture of Notary Public- Stat otF a
«ity LAURARCUBSEDGE
fission # HH 013089
Commission No. ':
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fission No. 7 :.. fission # HH013089
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. o/ b/ 20
MARTIN COUNTY BUILDING DEPARTMENT
_ 900 SE RUHNKE STREET
- STUART, FL 34994
(772)288-5916
permitting@martin.fl.us
Text:202-937-0892
ELECTRICAT, RISER D A AM
NOT TO SCALE
*Use for Temporary Construction Power Pole and Single Family Service Change Only
For any other electrical applications apply Florida Building Code 107.3.5 Electrical
l . Wiring; Services; Feeders & Branch Circuits; Over Current Protection; Grounding; Wiring Methods & Materials; GFCI
2. Equipment
3. Special Occupancies
4. Emergency Systems
5. Communication Systems
6. Low Voltage
7. Load Calculations
8. Design Flood Elevation
1. Size Service: 0 b A
2. Conductor Size: dCU ALUM
3. a. Meter Main: �®
b. Meter Can Only:
ze
CONSTRUCTION TYPE:
❑ Residential
® Mobile Home
Dual Electrodes or Test Required
❑ New Installation
❑ Old Installation
ADA Accessibility Disclosure Statement — This document may be reproduced upon request in an alternative format by
contacting the County ADA Coordinator (772) 320-3131, the County Administration Office (772) 288-5400, Florida Relay 711, or by
completing our accessibility feedback form at www.martin.fl.uslaccessibility-feedback.
Rev. 01-21