HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 712 11202 1 Permit Number:
VJ 1
Building Permit Application
Planning and Developmen r Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue,Fort Pierce F134982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:Service Change; Panel Change
PROPOSED IMPROVEMENT LOCATION:
Address: 324 Holly Avenue,Port St Lucie, FL 34952
Property Tax ID t#: 3419-510-0246-000-1 Lot No.
Site Plan dame: Block No.
Project Name: VanOrden Emergency Repair
DETAILED DESCRIPTION OF WORK:
Remove meter,riser,Indoor pane and breakers,cut old panel out of clothes closet,install new panel outside bedroom,(back to Back),
build new 150 amp service,locate source of fire,and correct any deficiencies, install new breakers,return to label panel
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank T 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:$ 2385.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Larry and Dee VanOrden Name:Donald Green
Address:324 Holly Avenue Company:Don Green Electric
City: Port St Lucie,Ft_ State:_ Address:1305 W 1 St St
Zip Code: 34952 Fax: City: Fort Pierce State:FIL
Phone No.706-8180366 Zip Code: 34982 Fax:
E-Mail:vanordend*bellsouth.not Phone No(772)418-5739
Fill in fee simple Title Holder on next page(If different E-Mail permits@ dongreeneiectric.com
from the Owner listed above) 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:
DESIGN ER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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.Lucle 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,1 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 int nd to obtain financing,consult
with der or an a e before commencingwork or rec 'n our No of Commencement.
i
Sig of Owne ssee/Contractor as Agent for Owner Sig ature of Contracto der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF a,—,, COUNTY OF a,—,d
Swo n to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this_day of 12020 by this_day of 2020 by
D►101IC4 reev-, Gt—e-c ,
Name of person making statement Name of person making statement.
Personally Known ` OR Produced Identification Personally Known '�z OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida I (Signature of Notary Public-Sta
LAURIE PHILL
Commission No.A y "'.':�¢,; �Se�IIaURIE PHILLI Slgm fission No.NN f�7B 2 _ �y iv Public-State of F ride
otary Public-State of londa "- ofrtmission p HH 8 2
Commission N HH 87 62 hrEy Commission Ez r s
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REVIEWS FRONT S VEGETATION SEATURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Jev.516/20