HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
LLc-LL
Permit Number;
t. L %rT_UC Al - _ 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 - Service Change
PROPOSED IMPROVEMENT LOCATION:
Address: 1201 W JOY LN, Fort Pierce, FL 34945
Property Tax ID #: 2303-610-0044-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Landcraf[ Inc
DETAILED DESCRIPTION OF WORK:
Trench from home to pole. Install FPL conduit. Back fill trench to 1 foot below grade and drop in marking tape.
Build stand alone 100 amp service. Re -teed home and associated receptacles etc.
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
Electric —Plumbing —Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 2200.00
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Wayne Savage
Name; Donald Green
Address: PO Box 12011
Company: Don Green Electric
City: Fort Pierce State: T
Zip Code: 34979 Fax:
Phone No. (772) 528-3815
Address:1305 W 1 st St
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No (772) 418-5739
E-Mail: landcraftinc@gmail.com
Fill in fee simple Title Holder on next page I 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:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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.
Lucl�County an posted on the jobsite before the first insp ion. If you intend to obtain financing, consult
with coder or a attornev before commencing work or re ine vourWotice of Commencement.
7 Jlr�� �_
-3--
Sig t re of Own a/Contractor as Agent for Owner
Sig ature of Contractor/License Holder -
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Bi'0Wo11_,4
COUNTY OF B �Gtr d
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
_k::�Physical Pres nce or Online Notarization
Physical Presence or Online Notarization
_202P
this � day of I by
this I day oflf.ty 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known �OR Produced Identification
Type of Identification
Type of Identification
Produced /
Produced
(Signature of Notary Public- Stat of Florida)
(Signature of Notary Public- St
;: ti LAURIE PHIL L
�„�S9bm
',
Commission No. ,``+� LAURIE PHI
�i�,[�y Public -State o�
���iss n No. bin`
_�otary Public-stat
Commission N H
of Florida mission t HH B
B7B82 ?, a�� My COr"'nission EN
February ol,
[ tr8� feaf-r
2025
REVIEWS FRONT
VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. SJbllu