HomeMy WebLinkAboutROCHE APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
g lop Planninand Devement Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 4624553 Fax: (772) 462-1578
Address: 2744 S BROCKSMITH RD FORT PIERCE, FL 34945
Property Tax ID #: 2320-501-0056-000-4
Site Plan Name.
Project Name: ROCHE
GENERATOR INSTALLATION
New Electrical Meter
Second Electrical Meter
Residential X
Lot No.4
Block No. 4
Additional work to be performed under this permit —check all that apply:
_Me nical _ 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: $ i i G G C1( Utilities: _ Sewer _ Septic Building Height:
NameMIRIAN ROCHE & AMBER D HOPKINS
Address:2744 S BROCKSMITH RD
City: FORT PIERCE
Zip Code: 34945
F
State:
Phone No,561-762-7141
E-Mail: mroche@bellsouth.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:GARETT GUIDROZ
Company:COMPLETE ELECTRIC INC
Address:637 SEBASTIAN BLVD
y: SEBASTIAN
Cit
Zip Code: 32958
Phone No772-388-0533
State: FL
Fax: 772-388-2411
E-Ma i I cregan@completeelectricinc.com
State or County License EC0001911
If
value
of
construction is
2500 or more, a RECORDED Notice of Commencement is required.
If
va1ue
o4
HAVC is $7,500
or more, a RECORDED Notice of Commencement is required.
SU'PF'LEMEN`CALCONSTRUCTlON LIEN LAW (;(FDRMAT(:ON:II
., :;
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 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 4obsite before the first inspection. If you intend to obtain financing, consult
with lender e mencing work or recording our Notic end.,
SignatWp4e of Owner/ Lessee/Contractor as Agent for Owner
Signatur .Li o der
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF & V
Sworn to (or affirmed) and subscri before me of
Sworn r affirmed) and subscribed before me of
Physical Presence or Online Notarization
hysical Presence or Online Notarization
thiseyL, "day of 4 E 2 y
this day of E by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Know OR Produced Identification
Type of Identificatio n.
Type of Identification
Produced
Produced
(Signature of Notary ublic- State of F orida)
(Signature of N tary Public- Sat Florida )
tt c,
Commission No. 'b 1 �; 81 (Seal)
Commission NJO ar (Seal)
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DATE
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Sep 19, 2024
COMPLETED
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