HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Uwe
.T;
if
p '1
Building Permit Application
Phnni
and Development Services
Baildi
and Code Regulation Division Commercial Residential X
2.00 V
rginia Avenue, Fort Pierce FL 34982
PhonE1
(772) 462-1553 Fax: (772) 462-1578
P=RNIIT
APPLICATION FOR: Electrical
P-3OPOSED
IMPROVEMENT LOCATION:
Address: 13827 S Indian River Drive, Jensen Beach, FL 34957 - Lake Manor Park Cooperative Site 24
Prooertd Tax ID #: 4509-805-0024-000-9 Lot No.
SitE Plan Name: Lake Manor Lot 24 Block No.
Pro ect dame: Lake Manor Lot 24
DTA�LED DESCRIPTION OF WORK:
Ins -all
w meter main, new mast, new weatherhead, and new ground rods. Meter #: ACD2176
New Electrical Meter Second Electrical Meter.
CONSTRUCTION INFORMATION:
Ad litional work to be performed under this permit — check all that apply:
^M chanical ^ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
El ctric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Tot31 Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of 1* onstruction: $ $1,500.00 Utilities: —Sewer —Septic Building Height:
CIWN �R/LESSEE: CONTRACTOR:
Name ancy J & Edward E Rothrock Name: James Brown
Addres :2550 SE Charleston Drive Company: Jim Brown Electric, LLC
City: Fort St. Lucie, FL State: Address:3352 NE Skyline Drive
Zip Ccde: 34952 Fax: City: Jensen Beach State: FL
Phone D. Zip Code: 34957 Fax: Ofc# 772-209-0280
E-Mail: Phone NoCell# 860-803-5333
Fit in fee simple Title Holder on next page ( if different E-Mailidb5333@gmail_com
from tf I ie Owner listed above) State or County License 30871
If vE lue of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If vE lue of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
S-IJPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Narr
AJdi
C ty:
Z p:.
ER/ENGINEER: _ Not Applicable
Phone
FEE SI VIPLE TITLE HOLDER:
Name
AJdr s:
C ty:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:_
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
_Not Applicable
OVJNEI�/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ce-tify -hat 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
whiith is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
stricture. Please consult with your Home Owners Assoclation 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 a=cordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The follc'. ing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessor structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARN III II�1G 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
w01 lender or an attorney before commencing work or recording your Notice of Commencement.
of Owner/ LesseejCan#ractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF1ry---N&_—A-ALCA
Sv-orrn tI, (or affirmed) and subscribed before me of �hysical Presence or Online Notarization
th s'iQ4 day of , 2021 by
, 31 G— —'>
NE me ol` person making statement.
Pesonlly Known �LC OR Produced Identification
Tyre of Identification Produced 1u� ; ctc_ ❑r,i.c� t' lip,
I' (_' _ C_o
(Sgnature of Notary Public- State of Florida )
Cc nmission NoC' (� rl S 10 0 1 (Seal)
WiTil
DATE
RE LE D
DATE
CCIMP.,ETED
FRONT ZONING
COUNTER REVIEW
KAREN CODERRE
MY COMMISSION # GG 9810GI
EXPIRES: April 23, 2624
Banded tm NoWN Public Undenrti[ers
SUPERVISOR PLANS VEGETATION SEA TURTLE
REVIEW REVIEW REVIEW REVIEW
MANGROVE
REVIEW