HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/2/21 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION: 1101 FLEETWOOD LN
Address: 1101 FLEETWOOD LN
Property Tax ID #. 3404-806-0009-000-6
Residential x
Lot No.
Site Plan Name: Block No.
Project Name: Wilson Residence
DETAILED DESCRIPTION OF WORK:
Install a new 60A feed to the A/C AHU fora 10kw heat strip
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
)� Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 750.00
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Thomas Wilson
Name. Michael Pride
Address: 1101 Fleetwood Lane
Company: Pride Electrical Services of Florida
City: Fort Pierce State:
Address: 843 S Kings Hwy, 102-B
Zip Code: 34982 Fax:
City: Fort Pierce State: FL
Phone No.
Zip Code: 34945 Fax: 772-461-2778
E-Mail:
Phone No 772-370-6894
Fill in fee simple Title Holder on next page ( if different
E-Mail mike@pride-electrical.com
from the Owner listed above)
State or County License EC13005859
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 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 �,e jobsite before the first inspection. If you inten to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of C, mmencement.
Signature of Owner/ Lesseekdntractor as Agent for Owner
Sigtn'ature of ontractorYI.Vense Holder
STATE OF FLORIDJ
COUNTY OF
STATE OF FLORIDA Is
COUNTY OF
Swor to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
i
P�ysical Presence r Online Notarization
this day of c.✓, 202 by
v` Pical Pres nce or Online Notarization
!YS
this day of , 202t by
Lad
vet
� ,�
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known;-' OR Produced Identification
Type Qf Identification
Type of Identification
Prr, uce
Pr used
(Signature of Notary Public- State of Florida )
(Signature of Notary Public- State of Florida)
y David Raymond Prue
�t�R David Raymond Prue
Commission No. o� M 9 RY PUBLIC
Commission No. ° NOTAf�LIC
o TA E OF FLORIDA
STATE OF FLORIDA
? Comm# GG287052
C t9 Expir
s 1 /26/2023
Expires 1 /
/22Q'�
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