HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Z. LCII cLL
EY �' ```"` Building Permit Application
Planning and Development Services
Building and Code Regulatton Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR -
'Meter can and service riser
PROPOSED IMPROVEMENT LOCATION:
Address: 200 OLIVE AVE Port Saint I �3r FI �4q5�
Property Tax lD N: _ _ _ Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORIt:
Replace meter Main and service riser NO a prade_of service nr service amp. Replace mpfPr main
because riser damage
New Electrical Meter Second Electrical Meter (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
Electric J Plumbing _ Sprinklers — Generator Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction:$ 1000.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ryan .iirrin
Name: George Ruiz
Address: -2nn O IVE AVE
Company: Impedum Electric Ilc
City: ^ Part Saint I imita. FL State: F
Zip Code: 34452 Fax:
Phone No. 7799 370318 E-
Address: 534 NW Mercantilerl c� iitP 9 06
City: Port Saint l tir.ie FI State: FL
Zip Code: 34986 Fax:
Phone No 772 2, lB
Mail: imperiumelectricllc(d.)gmail. com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail imnarii imalarttrirllrrr7nmgiLCnm
State or County License_ EC13009338
IIf 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.
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 conflicts with and 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 yourproperty. A Notice of Commencement must be recorded in the public records of St.
Luca a and po - -on the Jobsite before the first inspection. If you intend to obtain financing, consult
len land
rbey before co-mmencing work or recording our Notice of Commencement.
to of caner/ Lessee/Contr r as Agent for Owner
STAT OF FLORIDA �jj
ST
CO NTY OF O�� C�SL
Sworn to (or affirmed) anp subscribed before me of _4L Physical Presence or Online Notarization
this j?�_ day of t c.7e 202_L by
,er J j,Lip- Q(z-n�
Name of person making statement.
Personally Known —X OR Produced Identification
Type of Identification Produced
(Signature f No ary Public- State of Florida)
Commission N0. (Seal)
Tsar+ti'., YAaYRAh1ARTINEZGONZALEZ
t�//•�`; Notary Public • State of Florida
f 1 y�l Commission # HH 37410
'�?oar Aug 30, 2024
rv7 My Comm. Expires
ionded through National Notary Assn,
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