HomeMy WebLinkAboutCremins Building Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercia
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
� PERMIT APPLICATION FOR: Electrical
Residential X
I PROPOSED IMPROVEMENT LOCATION: I
Address: 1725 NW Buttonbush Circle, Palm City, FL 34990 -Harbour Ridge -Plat 18-Deermoss Village Lot 4 (OR1566-2592)
Property Tax ID #: 4426-835-0014-000-5
Site Plan Name: Cremins
Project Name: Cremins
DETAILED DESCRIPTION OF WORK:
Install New Main Breaker Panel 200 AMP due to uninsurable Panel.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
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
Cost of Construction: $ 2,400.00
OWNER/LESSEE:
Name Gerald E Cremins &Susan Cremins
Address: 180 Pond View Drive
City: Port Washington, NY State:
Zip Code: � � 050 Fax: n/a
Phone No.516-652-4543
E-Mail:
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name;James D Brown
Company: Jim Brown Electric, LLC
Address:3352 NE Skyline Drive
City: Jensen Beach State; FL
Zip Code: 34957 Fax: Ofc#: 772-209-0280
Phone No Cell #: 860-803-5333
E-MailJdb5333@gmail.com
State or County LicenseSLC 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 CQNSTI�UCTIQN LIEN LAVIf INFQRMATIfJN:
DESIGNER/ENGINEER: _Not Applicable
Name:_
Address:
City:
Zip:
Pltiane
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City;_
Zip: Phone:
MORTGAGE COMPANY: _Not Applicable
Name:
Address:
State: City:
Zip: Phone:_
_Not Applicable BONDING COMPANY:
Name:
Address:
City'
Zip: Phone:_
State:
Not Applicable
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 Caunty 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 Assoaation rules, bylaws ❑rand covenants that may restrict ❑r prohibit such
structure, Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
Inconsideration 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 5t.
Lucie County and posted on the jobsite before the first inspection. If you intend t❑ obtain financing, Consult
with lender or an attorney before commencing work or recording your Notiee of Commencement.
ature of Owner/ Lesse�antractor as Agent fgrlOwner
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of Contract�License Holder
STATE OF FLORIDA f STATE OF FLORIDA
COUNTY OF � v- �-,'n I COUNTY OF ,rv��,.--�-+'+'1
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
!��ysical Presence or Online Notarization ��ical Presence or Online Notarization
this i7cs'�"day of _ +v-. �L 202� by this �a''"day of � r-.:. •_, , 202Q by
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Name of person making statement. Name of person making statement.
Personally Known �� OR'Produced Identification � Personally Known �R Produced Identification
Type of Identification Type of Identification
Produced - � � s L • + , Produced � • c� r,' rC t.� Car• �z
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Commission No. $ I Uo ( (Seal)
Commission No.G�-mil �"IOu ► (Seal
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"+�'"• . KAREN CODERRE
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