HomeMy WebLinkAboutPermit 2103-0022 Electrical Temp Pole - 1126 Orange AveAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/22/2021 Permit Number: 2103-0022
I L1�1�CIL yR
L 0 1 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 - -temp Power Pole
PROPOSED IMPROVEMENT LOCATION:
Address: 11652 ORANGE AVE
Property Tax ID #: 2309-210-0000-000-9 Lot No.
Site Plan Name: 09/35S/39E Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install Temporary for construction power pole.
New Electrical Meter X 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: $ 500.00 Utilities: _ Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameTindall Holdings II LLC
Name: Daniel Stubbs
Address:201 Campbell RD
Company: S&W Electric, Inc
City: Fort Pierce State: F
Address: 501 W Coker Road
Fort Pierce FL
City: State:
34945
Zip Code: Fax:
Phone No.
Zip Code: 34945 Fax:
E-Mail:
Phone No 772-464-6466
Fill in fee simple Title Holder on next page ( if different
E-Mail jessicastubbs.swelectric@gmail.com
State or County License EC13007544
from the Owner listed above)
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.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of ciner essee/Contractor as Agent for Owner Signature of Con actor/License Holder
STATE OF FL R DQ STATE OF FL0,RJDA
COUNTY OF . t�,�(_'� COUNTY OF "4- j,C,il'
Sworn to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known ,/ OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- Stat
..i"� LAURAR.CUBBEDGE
Commission No. WIon # HH� 013089
' October 21, 2024
Boded Tin Troy Fain
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Swo to (or affirmed) and subscribed before me of
✓Physical Presence or Online Notarization
this day of . 2020 by
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
re of Notary Public -
Commission No.
SUPERVISOR I PLANS I VEGETATION
REVIEW REVIEW REVIEW
CAURAR.CUBSEDGE
r�san ' HH 013089
October 21, 2024
Bonded Ttn Troy Fam Wwano
SEA TURTLE I MANGROVE
REVIEW REVIEW
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