HomeMy WebLinkAbout65 S Las Olas DrAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
�'r WCE
Building 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 - Interlock Kit
PROPOSED IMPROVEMENT LOCATION:
Address: 65 S Las Olas DR, Jensen Beach, FL 34957
Property Tax I D ti: 4511-500-0055-000-6
Site Plan Name:
Lot No.
Block No.
Project Name: Kevin Roberts
DETAILED DESCRIPTION OF WORK:
1) Pull meter, remove existing 100 amp disconnect. 2) Install a 4 circuit disconnect and interlock kit. 3) Install 50 amp inlet box.
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
Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1477.00
Generator
^ Windows/Doors Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Kevin Roberts
Name. Donald Green
Address: 65 S Las Olas DR
Company: Don Green Electric
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. (213) 315-7639
Address:1305 W 1 st St
City: Fort Fierce State: FL
Zip Code: 34982 Fax:
Phone No (772) 418-5739
E-Mail: k_roberts390aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Permits@dongreenelectric.com
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER- — Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
UVVNtK/ LUN I KAL I UK 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.
Lu County and popeyed on the jobsite before the first inspection. if you in7*�end to obtain financing, consult
w' h ender or an at;(&npv hpforp rnmmpnrina wnrk- nr rarnwRhin vn AFn+�, _f
5 gn ure of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
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COUNTY OF t--
Sw r to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
� Physical Presence or Online Notarization
this 2 day of V L410e— __ , 2020 by
thi s 24 day of _.J[�. rZ� 2024 by
`�0/1I a c C-2i—eek?
TJ!9t-4—_4 1 d G mac-'_,
Name of person making statement.
Name of person making statement.
Personally Known J-0 OR Produced Identification
Personally Known _—<D_ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- t!�. rida LAUME PHI
1ign
ure of Notary Public- Sta
Notary Public -State of
Florida
LAUAII; PHIL
Commission No. Z ' Se5p ission M HH 8
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February Q1, 202
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REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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