HomeMy WebLinkAboutBUILDINGPERMITAPPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/20/21
Permit Number:
IT auc�u
C Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITAPPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 15305 MIDWAY RD FT PIERCE, FL
Property Tax ID q: 3201-133-0005-000-0 Lot No.
Site Plan Name: Block No.
Project Name: DIVISION OF EMERGENCY
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING ATS INSTALL (1) EMERGENCY MAIN MDP (1) GENERATOR DOCKING STATION. (1)GENERATOR LOAD
BANKING STATION.
New Electrical Meter Second Electrical Meter (Affidavit required)
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: $ 192,000 Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name SLC % Management & Budget
Name: GEORGE A RIVERA III
Address: 2300 Virginia Ave
Company: DOC WATTS ELECRIC INC.
City: Ft. Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-462-1100
Address: 6984 VENTURE CIRCLE
City: ORLANDO State: FL
Zip Code: 32g07 Fax:
Phone No 407-243-2278
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail PERMITS@ DOCWATTSELECTRIC.COM
State or County License EC13004296
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
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
_
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ 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 Count yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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 attorney before commencing work or recording our Notice of Commencement.
Daniel Retherford Digitally signed by Daniel eetherford
Date: 2021,08.26 08:19:58-04.00'
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF 5T LuuE
Sworn to (or affirmed) and subscribed before me of Physical Presence or _ Online Notarization
this .2Lday of Ag&tST ,202t by
,LANIf.L l? i'T4ffe2F0ljb
Name of person making statement.
Personally Known, / OR Produced Identification
Type of Identification Produced Aac 'j>f y7A Sw^46
(Signature of No ary Public- State of Florida,,,
,••MELISSA& BOEOKECommission NC 9(S GSL 26
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