HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST SE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/27/2021
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Permit Number:
Buoildoing Permit Application
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, fort Pierce FL 34482
Phone: (772) 462-1s53 fax: (772) 462-1578
PERMIT APPLICATION FOR:
Commercial _ _ Residential
j PROPOSED IMPROVEMENT LOCATION•
Address: 53(lR Hif"lrnn, n:.,,,. C_.. r..___ _ r-. ,. ..
ro pe rty Tax I D #
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Electrical Service U
rode Electrical Panel Upgrade 125/200
New Electrical Meter Second Electrical Meter (Affidavit required}
CONSTRUCTION INFORMATION.
Additional work to be performed under this permit — check all that apply;
`Mechanical _Gas Task � Gas Piping ` Shutters
V Electric
Plumbing
Total Sq, Ft of Construct -ion:
Cast of Construction: S 4�567.46
OWNER/LESSEE:
Marne Sandra. Maa+
Address:. 5308 H'Irk
City-
.
Pierce
Drive
Zip Code- a42,fi Fax:
.
Phone No. f 77.r%A
Sprinklers
Generator
Lot No.
Block Na.
.Windows/Doors
Roof
SC(. Ft. of First Floor.
Utilities: ` sewer � Septic Building Height:
state: FL
E-M-aii:
...... ....
Fill in free simple ritle Holder on next page (if different
from the Owner listed apove)
CONTRACTOR:
Name: Lazaro Yac Leciorburo
Pond
Pitch
Company: Ame6na St wide Electrical, (;c)ntiactoi
Address: 9571 NW 24th ST
city-, Sunrise State: FL
Zip Code: 33322 Fax:
Phone No
E-Mail I
OWN
6.0
0
y
State or County License EC 13009593
if watue of consbuton is ZSW or more., a RECORDED Notice o Commencement is required.
If value of MW ,SW or nw, a RECORDED Nome of Commencement is required.,
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _✓ NotApplici-ible I MORTGAGE COMPANY: ✓ Not Applicable
No w e A (i d i ess'
City:.. ---...-- —State:
Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
i Name's
Address:`
City1
:
Zip: Phone:
Name.
Address.
City: State.
Zip: Phone:
BONDING COMPANY:
Jane;
Address:
city:
zi P Phone:
v Not Applicable
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 permit.
St. Lixie Comity makes s o representation t that igranting apermitwill a ut�ori zthe permit holder to build the su b'e t structure
l" `ppOwners Association rule bylaws or and covenantsaa or prohibit
%tT X-t re, Please consult with your Home Owners Association ilard review your deed for any restrictions which may apply.
III c 0l)SI r do Of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
it) accordince 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.,
accessorV structures, swimming peals,
fences,
walls,
signs, screen rooms and
accessory uses to another
non-residential use
WARN I NG TO OWNER: Your failure to Retard a Notice of Commencement may result in paying twice far
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 your Notice of Commencement,
Sigriature of Owner/ Lessee/Contractor as Wgent for owner
STATE OF FLORIDA
COUNTY OF
Svu {or affirmed
this�iay of �y
f�
�z ) y j
and subscribed b ore me at
2 by
Name of person making statement.
Personally Kn own OR Produ
Type of Identification Produced
Identification
11
MICHAS, WHALE
416M
Physical Presence or Online Notarization
(Signature of Notary Public- State at Florida )
Commission No. � Seal '`�a MICKULi HAL JB
EJ�VIRE�; der 17, 2Q2i
REVIEWS
DATE
r RECEIVED
DATE
COMPLETED
FRONT
CO UN
R—eV5120/21 --- ---
ZaNING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SSA TURTLE
REVIEW
MANGROVE
REVIEW
Ii