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HomeMy WebLinkAboutPermit Package All APPLICABLE INFO MUST BE COMP LETED FOR APPLICATION TO BE ACCEPTED _ Date: �31ac1 Permit Number: RECEIVED QOD4wil" SEP 2 3 2021 Building Permit Application 5t.Lucie County Planning and Development Services Permitting 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: S, P;ROPOSED.IMPROVEMENT.LOCATI'ON: Address: 49 14 Fo-aT P1tl2C� f F1_ . 5� 1 4 7 Property Tax ID#: 1) C) I ®D©-`�/ • Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK:,-"; New Electrical Meter Second Electrical Meter X (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 ')C Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ �© Utilities: —Sewer _Septic Building Height: OWN ER/LESSf E: CONTRACTOR: Name cTu !-to (7�)0 -7-A tZ,7 Name: �cOr 6�-- K G Address: 41 t 4 0rZAo(,E Company: 1`=1 Iy(� +o WZ-P—'��l5 City: -f6 Vz-% r'1'6-P-GF1 State:fL Address:1 16 cl-e q Ll V AL—DACI k 6l-V b Zip Code: - 'T q 4-1 _Fa11x::11 City: State: rt- Phone No. Zip Code: `I-`7 O Fax: E-Mail: Phone No 'C,1 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 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 LAIN INrFORMATION 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 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. Signature of Owner/Lessee/Contractor as Agent for Owner STATE OF FLORIDA af 1 -u(I , _COUNTYOF o Sworn to(or affir , d)a •d subscribed befor me of Physical Presence or Online Notarization this Ik day of 0 �by , Name of person making statement. Personally Known OR Prod sed Idep�if* ation Type of Identification Produced{, 0c (Signature of Notary Public-State of :oi*�1Y0ys'•. POLINASOROK.A Commission N =S i' Notary Public-State of Florida ;+FOFrti��Q,•' Commission p GG 263732 My Comm.Expires Oct 1,2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETE D ev 5/20/2 Coy �3 �T, y o:_ �2 Electrical Affidavit Date Wq /2c'a I Parcel ID# �1�7"� �� — [ � ' OOc�a Address Permit# I have requested to install an additional electric service/meter at the above named property. By signing this affidavit, I fully agree that the additional electrical service/meter does not allow for the following: • Operation of a business venture or entity within the accessory structure • Renting or leasing any portion of the accessory structure • Converting accessory structure into additional occupied or living space I fully understand that if the conditions of this affidavit is found in violation, power may be shut off to the building without notice. Print Owner's Name Signature of Owner STATE OF FLORIDA,COUNTY OF ca . wai e SWORN TO(OR AFFIRMED)AND SUBSCRI ED BEFORE ME OF v PHYSICAL PRESENCE OR ONLINE NOTORIZATION THIS DAY OF-k1j:jj�jE 20=-Jjt� Ij NAME OF PERSON MAKING STATEMENT / PERSONALLY KNOWN OR PRODUCED IDENTIFICATION TYPE IDENTIF CATI PRODUC D f-W1ridC1 Ner Li (QX1�5� lie, -Awin Leer' SI NATURE OF N ARY PUBLIC TYPE OR PRINT NOTARY COMMISSION NUMBER Sheltie Ann Leeder A NOTARY PUBLIC (S- _STATE OF FLORIDA $Comm#GG256069 Expires 9/29/2022 PLANNING&DEVELOPMENT SERVICES BUILDING DIVISION 1 2300 Virginia Avenue I Fort Pierce,FL 34982 %- (772)467-1553 EM (772)462-1428 (772)462-1578 Q-,v\vw.stlucieco.gov FPL POLE EXISTING 125A PANEL INSIDE GARAGE OFED FROM HOUSE NEW UNDERGROUND 200A METER MAIN WITH 125A BREAKER FOR GARAGE NEW 1 PVC CONDUIT #1 COPPER X3 #6 GROUND NEW UNDERGROUND 2" PVC SCH.40 TO POLE FILE %U'O'Upy NEW PT 6X6 POST ENCASED IN CONCRETE KING POWER SYSTEMS INC. Julio Cesar Gonzalez NEW UNDERGROUND SERVICE 1110 Summit Trail Circle, Unit B 4914 ORANGE AVENUE FOR EXISTING GARAGE K P S El 0 0 West Palm Beach, FL 33415 FORT PIERCE FLORIDA 34947 GEORGE KING LIC.# EC13008022 PH 561-602-8765 ' OWN BY.X ENG BY:RK CHK BY.RK DATE: 7-6-2021 SCALE: NONE