HomeMy WebLinkAboutBUILDING PERMIT APPLICATION ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/04/2021 Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: LAS PALMAS (PB 46-2)TRACT A(0.18 AC) (AS PER PLAT DEDICATION DATED 3-1-2005)
Property Tax ID#: 3415-504-0002-000-4 Lot No.
Site Plan Name: SP-6438 Las Palmas Way#CAN Block No.
Project Name: Comcast Power Supply Cabinet- JB 690527 6438 Las Palmas Way#CATV
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install new Comcast power supply cabinet & 20 amp 125 v 96 duplex aluminum service feeder at FPL
Transformer T3 located on the east side of Las Palmas Way, south of lift station & 625' north of
Kitterman Rd
CONSTRUCTION INFORMATION:
ACIcitional worK to De Dertormed under this permit—c ec a app y:
0HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Z✓ Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 825 S Ft. of First Floor:
Cost of Construction:$ 709.90 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Comcast - Anthony SDringsteel, Const Suov Name: Gary ] Gifford
Address: 3960 RCA Blvd, Ste 6002 Company: Gary J Gifford, Inc.
City: Palm Beach Gardens State: FL Address: 350 SW Linden St
Zip Code: 33410 Fax: City: Stuart State:FL
Phone No. Zip Code: 34997 Fax: 772-219-0146
E-Mail:anthony.springsteel@comcast.com Phone No. 772-286-0954
Fill in fee simple Title Holder on next page(if different E-Mail: giffelec@comcast.net
from the Owner listed above) State or County License: EC13001574
If value of construction is$250D or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: x_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.
1 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the fi st inspection. If you intend to obtain financing, consult wit lender or an alto ney before
commenciok work or rec rdin our otce of Commencement.
rSigna)Gr w el'i:es'seejtdfiirattor as Agent for Owner SignatOre of Contra / nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF nam COUNTY OF Mang
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 15thday of September .20 21 by this 15 day of September .2021 by
Sumn Carrasgunio Susan Carrasguab
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification_ Personally Known • OR Produced Identification
Type of Identification Type of Identification
Produced Produced f
xNowy'P,7-,Foil,
(Signature of Nota I t e C aW Si nature o t bl yp II
B ry j HH 0e7255 ( B l ur ornmsuon HH�7255
0wwt Expup t n 2a illlStli Exgraa 11112=4
Commission No. a Commission I o 2ss I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17