HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulotion Division Commercia) Residential
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical Service Panel Upgrade
PROPOSED IMPROVEMENT LOCATION:
Address: 2303 N 49th St, Fort Pierce, FL
Property Tax ID #: _1431-701-0175-000-6 Lot
No. Site Plan Name: _
Block No. Project Name:
Electrical service Panel upgrade
New Electrical Meter
Yes Second Electrical Meter.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical _Gas Tank _Gas Piping _Shutters
x Electric _Plumbing Sprinklers _Generator
Total Sq. Ft of Construction:
Cost of Construction: $
Windows/Doors _ Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CO
Name JT (?
N m
e
Address: D3(3 Q 'A CIS[ 41 �T --
City: rrys�fT Y ��'— � State:
Co pang.
Imperium ELectric
Zip Code: Fax:
L C
Phone No.
Address:-534
NW Mercantile Place
E-Mail:
City: Port St Lucie State:_FL_ Zip Code:34983
Fill in fee simple Title Holder on next page (if different
Fax:
Phone: 772-237-0318
from the Owner listed above)
No
E-
T
v.r i j m -L Ic-Ltr- -xt"nr I. co
If value of construction is 2500 or more, a RELURDED Notice of co` Nfe S$ c njr1i� eiise
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is require
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: NotApplicab'le
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 and posted on the jobsite before the first inspection. if you intend to ob4in financing, consult
•�i_ i _._ �_- .. ..��,......... l...inrn .-nm rina %AinrL- nr rarnrrplTavniir NntirP of r Pr1r.ement.
dyV-7 Q- �C
Signatur of Own / Lessee/Contract as Agent for Owner
Signatur f Contrar/License Holder
STATE OF FLORID&
STATE OF FLORIDA
S
COUNTY OF �.i
COUNTY OF C L
5 rn to (or affirmed) and subscribed before me of
worn to (or affirmed) and subscribed before me of
P ysical Presence or Online Notarization
hf is � day of u," 2020 by
Physical Presence or Online N tarization
this � day of � 202� by
Name o per n making statement.
Name o erson making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification_
Type of Identification
Type f Identifition
Produced
Prod d�o C1�
�JaNdm "WP
(Sig Iure of Notary Pub to Np 00276=
(Signature of Notary Public- State of Florida }
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/ZU