HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5 o2 Permit Number:�/2i��—QU b
,��
P a o, !
• Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Temporary Power Pole wi-W, rvt;+ #3 21d I-Ovg 3
PROPOSED IMPROVEMENT LOCATION:
Address:_4940 Waterson_Way, Fort Pierce FL, 34949
Property Tax ID#: ?5325yoCUU77000�
Lot No. Site Plan Name: i!5 Q.YY1)�! TE
Block No. Project Name: Temporary Power Pole
DETAILED DESCRIPTION OF WORK:
150amp temporary power pole, remove at early power release.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
Gas Piping
_ Sprinklers
Shutters _ Windows/Doors _ Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name John Cavnar _
Name: —John Cavnar
Address:_513 NE Sagamore Terrace,_
Company:_Goldstar Electric Inc.
City: Port Saint Lucie State: FL_ Zip Code: 34983
Address:_213 NE Sagamore Terrace,
_ Fax: Phone No._(772)380-5913_ EMail:
City: _Port Saint Lucie State:—FL—
johnc@goldstarelectric.com Fill in fee simple Title
Zip Code: _34983_ Fax:
Holder on next page ( if different from the Owner listed
Phone No: (772) 380-5913
above)
EMail_johnc@goldstar-electric.com State or
County Lice nse_EC:13002082
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:
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 attornev before commencine work or recordine vour Notice of Commencement.
Signature cf Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 5� . LU C'I .e
Sworn to (or affir ed) and subscribed before me of Physical Presence or _ Online Notarization
this day of t 1Q _ 20 by
if
Name of person making statement.
Personally Known IOR Produced Identification
Type of Id_tntification Produced
Notary Public- State
Commission No. Rif 6Co 3Lg'3
REVIEWS FRONT
COUNTER
DATE
DATE
ZONING
REVIEW
n=m N0r V Pub6C Siats otFW,da
is Paola Bautista Garcia
M, Ca ,,, ^ HH 080683
E.pM 1111512014_ _
SUPERVISOR
I PLANS REVIEW I VEGETATION EVIEWS REVIEW LE MANGROVE