HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/07/2021
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Permit Number:
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
PERMIT APPLICATION FOR: Electrical Service Change
PROPOSED IMPROVEMENT LOCATION:
Address: 13507 NW Coco Plum Ct, Palm City, FL 34990
Property Tax ID #: 4436-601-0028-000-8
Site Plan Name:
Project Name: Horrocks Residence
[DETAILED DESCRIPTION OF WORK:
Replace 400amp meter main service (same size).
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction: ,
Cost of Construction: $ 5649
Gas Piping
_ Sprinklers
Residential X
Lot No.28
Block No.
_ Shutters _ Windows/Doors _ Pond
Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Michael Horrocks
Name: Kent Blosser
Address:431 The Kingsway
Company: Blosser Electric
City: Etobicoke, ON State: _
Zip Code: M9A 3W1 Fax:
Phone No.610-999-2930
Address: PO Box 7305
City: Port Saint Lucie State: FL
Zip Code: 34985 Fax:
Phone No772-337-0055
E-Mail:mjcivi12@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Electricinc.info@gmail.com
State or County License EC13001570
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.
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: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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"vvNL-ni Lijim r nA% r vn Arriuviiii : Hppiicailon is nereby 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: You t re to Record a Notice of Commencement may result in paying twice for
improvements toy pro erty. A Notice of Commencement must be orded in the public records of St.
Lucie County an osted n the jobsi efore the first inspection. I intend to obtain �irr�ncing, consult
with lender an atto ev before encing wnrk nr rprnrrl4na�li it Nntirc of ('r%mm
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLOJRlQDA
STATE OF FLORIDA
COUNTY OF ,L,W
COUNTY OF S�, J_jI&e
Swo n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Swyn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this L day of 3L.1 2020 by
this Z_ day of ,)k tf)� by
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Name of person making statement.
Name of person making statement.
ng
Personally Known V OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. ; :�"�'�' . A"SONIOANSON
Commission No. •.,
A ANSON
MY COMMISSION # GG 970043
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