HomeMy WebLinkAbout20211004_Building Permit Application (Signed & Notarized)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/04/2021 Permit Number:
~Uo ILCTJJ~D~ ---~,.,,~ cca5if7.siru-~ --~ 0 .. ~ ---····· ":S,;,~ .,,. l1 llwra "r1 o • ~ Building Permit Application
Planning and Development Services
Commercial I I
Residentia l L ✓ I
Building and Code Regulation Division !
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding I
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION :
Address: 7802 PENNY LN, FORT PIERCE, FL 34951
Property Tax ID#: 130160703680007 Lot No. 9
Site Plan Name: Block No. 86
Project Name :
I DETAILED DESCRIPTION OF WORK: I
BEeL8CE ELECIBIC8L e8~EL 8~0 MEIEB C8~
New Elect r ical Meter[_ ✓ I Second Electrical Mete rl _ l (Affidavit required) --
I CONSTRUCTION INFORMATION: I
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: N/A Sq. Ft. of First Floor: 1,680
Cost of Construction:$ 2,150.00 Utilities: l Sewer I Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name TIMOTHY ZERBE Name: TODD A TOUSSAINT
Address: 7802 PENNY LN company: TOUSSAINT ELECT RIC LLC
City: FORT PIERCE State: FL Address: 640 4TH PL #103
Zip Code: 34951 Fax: City : VERO BEACH State: FL --
Phone No. (772) 209-2283 Zip Code: 32962 Fax:
E-Mail: TIMOTHYZERBE@GMAIL.COM Phone No (772) 925-1223
Fill in fee simple Title Holder on next page (if different E-Mail INFO@TOUSSAINTELECTRIC.COM
from the Owner listed above) State o r County License EC13005072
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners 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
·th I d b f . k d. N . f C t WI en er or an attorney e ore commencing wor or recor mg your ot1ce o ommencemen .
~~-
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
Sworn to (or affirmed) and subscribed before me of I ✓ 1
Physical Presence or C Online Notarization
this 4TH day of OCTOBER 20_l1_ by
TODD A TOUSSAINT
Name of person making statement.
Personally Known [LOR Produced Identification I
Type of Identification Produced
L~
(Si o/~f Notary Public-State of Florida)
(S I) ,,,-:_~~~:;,,, JEREMY M CASSELL
ea -"~-'<-N otary l"u tlic-St.te o f Florida
~: ~~ Comm ,ss ien # HH 108375
C;.1-li 0.,'V My C0 mmiss i on Expires ,,,,,,~~t;\,,'' M tHCh 23 , 2025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/2U/21