HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�tL' ' 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
rtKMII AF'F'LIC:AIIUN FUK:New 100 amp service
I PROPOSED IMPROVEMENT LOCATION:
Address: 7830 Germany Canal rd
Property Tax ID #: 322921100030001
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Installation of new 100 amp service
New Electrical Meter x
Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential x
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: Sq. Ft. of First Floor:
Cost of Construction: $ $1,460.00 Utilities: _ Sewer _ Septic
OWNER/LESSEE:
Name Santos Ortiz
Address:
City: Port Saint Lucie State: _
Zip Code: 34953 Fax:
Phone No. 772 233 2112
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: Edwidge Bourdeau
Company: Power Electrical
Address: 4444 SW Grace Ct
City: Port Saint Lucie State: FI
Zip Code: 34953 Fax: 772 873 2576
Phone No 772 359 2635
E-Mail powerelectricalcoinc@yahoo.com
State or County License EC13007325
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.
Na Not Applicable
Address.
Zip: Phone State:
ME SIMPLE T1T1-E HOLDER: Not Applicable
Name:
Address,
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
CrtY=
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ce"fy that no work or installation has commenced prior to the issuance of a permit.
h in�oonfli rePtion that is granting a Permit will authorize the it holder to build the subject structure
prohy app cable Home Owners i
�tru Assoc anon rules cture. Please consult wrth your Home Owners Association and review your odeed fod many r�ic�dons�wh y apply, � such
n �nsiderallon of the granting of this requested permit, I do hereby agree that I will, in all respects, perfomn the work
n 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,
Iccessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
VARNN TO OWNER: YOUR FAMIM TO RECORD A NOTICE OF MAY RESMT N YOt= PAYNG
71110E FOR NPROYEIMENTS TO Tatm PROPEMY. A NO 10E OF MUST BE RECORDED AND
POST® ON TW JOB SITE BEFORE THE FIRST MIMPEC><fON. F YOU MIITEW TO OBTAN FNANCNG, CONSULT
rRM YOLIR LENDER OR AN ATFORlIEY BEFORE RECORD■rG YOUR NOTICE OF
5�8na er/ ssee/Contractor as Agent for owner
STATE OF FLORIDA ,
COUNW OF `iT
The ng instrument was acknowledged before me
this day of /`7/V , 20ZI by
Name of person malting statement.
Personally Known --79,— OR Produced Identification
Type of Identification
Produced
7
(Signatu Pu )
Commi V.NdSeal)
�n. &AW+D=&* e%tr8.d.
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of 20_ by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No.
REVIEWS I COUNTER I REVIEW I SUPERVISOR FRONT ZONING REVIEW I REVIEW PLANS I REVIEWON
DATE
RECEIVED
DATE
COMPLETED
(Seal)
SEA TURTLE I MANGROVE
REVIEW REVIEW