HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/23/21
Permit Number:
11
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Planning and Development Services Building Permit Application
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:ELECTRIC
PROPOSED IMPROVEMENT LOCATION:
Address: 1705 SWAIN ROAD
Property Tax ID#: 2418-313-0001-000-7
Site Plan Name:
TOLSON Lot No.
Project Name: TOLSON
Block No.
DETAILED DESCRIPTION OF WORK:
INSTALLING NEW DEDICATED CIRCUIT
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:
Sq. Ft. of First Floor:
Cost of Construction: $ 1048.55 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name KIM TOLSON
Name:JOHN PANKRAZ
Address:1705 SWAIN ROAD Company:ELITE ELECTRIC AND AIR
City: FT PIERCE
State:FL- Address:1691 SW SOUTH MACEDO BLVD
Zip Code: 34947 Fax: PORT ST LUCIE City: State:FL
Phone No.772-577-1868 Zip Code: 34984 Fax: 772-340-3702
E-Mail: Phone No772-340-3797
Fill in fee simple Title Holder on next page(if different E-MailPERMIT@ELITEELECTRICANDAIR.COM
from the Owner listed above) State or County License EC13006036
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: ,�C Not Applicable MORTGAGE COMPANY: k Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: k 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 conflicts with any,applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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,wal(s,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 attorne before commencin work or recordin our Notice of Commencement.
( �
Signature wner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Sr k UC iF
Sworn to(or affirmed)and subscribed before me of _1�Physical Presence or Online Notarization
this 2^) day of AJGuSt- 201-1 by
Name of person making statement.
Personally Known A _OR Produced Identification
Type of Identification Produced
(Signature of Notary Public-State of Florida) � _�-gym
KnNN ELENAE DEWITT
GG 14 `S Div � Notary Public—State of Florida
�.. <..
Commission No. (Seal} » �» '
,i »• Commission-GG 166915
pAy Comm.Expires Dec 10,2021
Bonded thrcugh Ivalional Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/20/2