HomeMy WebLinkAbout14187 Cisne Cir - Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/28/2021 Permit Number:
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A Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Interlock Kit
PROPOSED IMPROVEMENT LOCATION:
Address: 14187 Cisne Circle, Fort Pierce, FL 34951
Property Tax ID lt: 130E500-0007-OW-6
Site Plan Name: Spanish Lakes Fairways
Project Name:
DETAILED DESCRIPTION OF WORK:
PROVIDEGENERATORINTERLOCKKIT, INLET BOX,
PVC CIRCUT EXTENSION FROM EXISTINGPANEL LOCATION IN GARAGE OUT TO DRIVEWAY
New Electrical Meter No Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. 4
Block No. 37
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: 1822 Sq, Ft. of First Floor: 1822
Cost of Construction: $ 1082 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Robert Schmid
Name: Donald Green
Company: Don Green Electric
Address: 14187 Cisne Cir
Address: 1305 W 1st St
City; Fort Pierce State: _
Zip Code: 34951 Fax:
City: Fort Pierce State: FL
Phone No, 7725950478
Zip Code: 34982 Fax:
E-Mail: liquidjoy@ bellsouthn net
Phone No (772) 418-5739
FIII in fee simple Title Holder on next page I if different
E-Mail permits® dongreenelectric.com
from the Owner listed above)
State or County License EC13007447
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:
IGN
Name:_
Address:
Not Applica
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
Not Applicable
State. -
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Prone:
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.
Lucikiqounty apd posted on the jobsite before the first inspe bn. If you intend to obtain financing, consult
I I nder cd n attorney before commencing work or r di a vour Notice)of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sign ture of Contractor/License Holder
STATE OF FLORID II
STATE OF FLOR A
COUNTY OF CoLi,r d
COUNTY OF
Swore to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
t/ Ph sical Presence qr Online Notarization
/
lPhysical Presence or Online Notarization
s
this day of SLR to 2020 by
this j� day of c 2020 by
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- S
re of Notary Public- Stat
LAURIE PHILL LAURIE PH!
No. 15
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REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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DATE
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