HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Da([\tom�\\e: Permit Number:
R a Building PP 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: 247 Nettles Blvd
Property Tax 11)#: 4502-501-0433-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Altamirano
DETAILED DESCRIPTION OF WORK:
Install and provide a GFCl receptacle at or in each lamp post. Install 1/2"pvc conduit and pull wire.
Wire poles and receptacles. Install switch on front post.
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:$ 2080.00 Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Pablo and Antoinette Altamirano Name:Donald Green
Address:247 Nettles Blvd Company:Don Green Electric
City: Port 5t Lucie State: Address:1305 W 1st St
Zip Code: 34957 Fax: City; Fort Pierce State:FL
Phone No.(786)390-2607 Zip Code: 34982 Fax:
E-Mail:Antoinette_altamiranoC@yahoo.com Phone No(772)418-5739
Fill in fee simple Title Holder on next page(if different E-Mail Permits@dongreenelectric.com
from the Owner listed above) State or County License EC13007447
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 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.
Luci ounty and osted on the jobsite before the first inspe n. If you inten to obtain financing,consult
w' I nder or an ttorne before commencing work or reco i our Notice Commencement.
Sigoafore of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this__L_day of W 2020 by this__L day of V (_j r A 202V by
-Iof'Yi1 a 6rc'�y, J�pvJorI ,� G re e"
Name of person making statement. Name of person making statement.
Personally Known >6 OR Produced identification Personally Known kgO OR Produced Identification
Type of Identification Type of Identification
Produced n / Produced
�O V
(Signature of Notary Public-Stat of Notary Public-State FI ,)
i�l'f1y LAURIE PHI IPS
LAURIE PHI LIPS a
`�p//M����V,A��`4,""�1 � `�;?Notary Public-Sta e I Florida
Commission No.M '1� 2 _� 'Jotary Public-state n No '}�Ff 79b2 - l) Commission# 7862
Commission#H g2 =�onNw `\� My Commissionxpires
Commiaalon Expires February 01 21 25
REVIEWS FRONT ZONING SUPERVT-1 P VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.