HomeMy WebLinkAboutKimball permit app READY 8 29 21All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: July 6. 2021 Permit Number
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L c r L Building Permit Application
Planning and Development Services
Buadmgand Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Running electrical for new
PROPOSED IMPROVEMENT LOCATION:
Address: 5605 Eastwood Dr
Property Tax ID i1: 1301-613-0394-000-7
Site Plan Name:
Project Name: Gary Kimball
DETAILED DESCRIPTION OF WORK:
Run electrical for a new construction
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.6
Block No. 154
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
iElectric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq- Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: S 3550.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
Name Gary L Kimball and Mary Jane M Kimball
Address:5805 Eastwood Dr
City: Fort Pierce State:
Zip Code: 34951 Fax: —
Phone No. 772 224 1159
E -Mai I: gkiMba11504@gmail.com
Fill in fee simple Title Holder on next page ( if dffferent
from the Owner listed above)
CONTRACTOR:
Name: Cliff Ruff
Company: Vero Beach Electrical
Address:1006 Momirgside Dr
City: Vero Beach State: FL
Zip Code: 32963 Fax:
Phone No7724735245
E-Mai I cliff.rufl®yahoo.com
State or County UcenseEC13009242
It value of construction Is 25M or more, a RECORDED Notice of Commencement is required.
If value of HAVC is S7.500 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
—_
I Zip: Phone:
FEE SIMPLE TITLE HOLD R: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: I Name: -_..
Address: Address: _
City: City:
Zip: Phone: Zip: Phone:_
OWNER/ CONTRACTOR AFFIDVIT: Application is nereby 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 blue 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 appy.
n 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 Budding 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 your Notice of Commencement.
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Signature of r/ Lessee/Contractor di 111ililent for OwnerSignature of Factor/License Hol j
STATE OF FLOJPDAI STATE OF FLQRLDA
COUNTY OF X-r�0- 0,c v jev' COUNTY OF 0 --�y2��
Swofn to for affirmedl and subscribed before me of svw to (or affirmed) and subscribed before me of
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this _�Ld�ay of\\._^`J') ` 2020 by :nos dayof - J�Jt,�J , 2020 by
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Name of person making s tement. %ame of person makings cement
Persona .r Known OR Produced Identification. '' :�rsonally Known OR Prod"ced Identification
Type of Identification -�voe of Identification
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