HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //,,,, ��//�ff��j�
Date: 6/8/21 Permit Number: 10 t`J�U
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p ° p Building Application
Permit A lication
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:
PROPOSED IMPROVEMENT LOCATION:
Address: 2709 Bent Pine Drive
Property Tax ID#.. 1334-502-0011-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install manual interlock kit for portable generator
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
V Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 1,015 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Keith Hackett Name:Anthony luele
Address:2709 Bent Pine Drive Company:Atkinson Electric LLC
City: Fort Pierce State:_ Address:PO Box 644207
Zip Code: 34951 Fax: City: Vero Beach State:FL
Phone No.719-440-5316 Zip Code: 32968 Fax:
E-Mail:Jusdon12@comcast.net Phone N0772-302-7583
Fill in fee simple Title Holder on next page(if different E-Mailinfo@AtkinsonElectricSouth.com
from the Owner listed above) State or County License EC13009367
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
i
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.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing,consult
with lender or an attorney before con3mencing work or recording our Kotice of Commence ent.
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Si ature of Owner Less /Contractor as Agent for Owner 'Signature of Contra o/License Holder
STATE OF FLOR A STATE OF FLORIDA�. j
COUNTY OF ,tg, COUNTY OF �C.6tC_l
orn to(or affirmed)and subscribed before me of or to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of 2020 by this gof 2020 by
game of person Mking statement. Name of person mak' g statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
(IS
uced Pro' d d
SS' oil PA141
ature of Notary Pub State of Flor ) na ure of No ' S
#GG 275060
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REVIEWS FRONT @ Q VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20