HomeMy WebLinkAboutPermit App and SketchAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: d r
o )-- aC '-c,-,�J.ti,
PropertyTaxlD#: ' 1 2-30
Site Plan Name:
Project Name: G- 'S Cc -a
DETAILED DESCRIPTION OF WORK:
_. 1
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Lot No.
Block No.
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: Sq. Ft. of First Floor:
Cost of Construction: $ 1 F00 Utilities: —Sewer —Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name D,---�, ( G_' M a-n-Cs+'--tL 1
Name: 'I-k-
G�ce_� �,
Address: :-, -b't-L/, `'(.'C.
City: Wit- Lam, Q dl c State: FL--
Zip Code: 3 _3.3 3 cl Fax:
Phone No. ef Sq - ` t o ._ 3 C E-
Address: Gg ( f1i-JJ r„i
City: i ,+} . L_v c 1 e_ State: PL_
Zip Code: 3 `f (7 H, Fax: _-? 72LN l� lc
Phone No—71 2-cf) --2-Lars'0
Mail: rct`�,,-)cfsocj -�crii ��_�1 cor i
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail_Q��JZ
State or County License[��C (30 _;.'/ `�_
It 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:
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: —
Address:
City:
Zip: Phone:
MORTGAGE COMPANY
Name:
Address:
City:
ZIP Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
— Not Applicable
State:
`Not Applicable
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
with lender or an attorney before commencing work or recording our Notice of Commencement.
blgqatu f ner/ Lessee ontractor as Agent for Owner
STATE OF FLORIDA I
COUNTY OF /iJ7rz ii l
Sworn to (or affirmed) a d ubscribed before me of Physical Presence or Online Notarization
this 2 day of 20Z-/ by
Name of personvimaking state. ent.
Personally Known OR produced Identification
Type of Identification Preduced'
(Signature of Notary Public- State offFlorida
Commission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
CYNTHIA D. TUNING
MY COMMISSION # GG 367784
EXPIRES'. September 23, 2023
Bonded Thru Notary Public Underwriters
PERVIS
S EGETATIEATURTANGRO
REVIEWOR REV EW I VREVIEWON I S REV EWLE I M EVIEWVE
L-LIL4- A K19-AL IUL%ItX "' - ' '
NOT TO SCALE
For any other electrical applications apply Florida Building Code 107-3.5 Electrical
1. Wiring, Services; Feeders & Branch Circuits; Over Current Protection, Grounding; Wiring Methods & Materials; GFCl
2. Equipment
3. Special Occupancies
4. Emergency Systems
5. Communication Systems
6. Low Voltage
7. Load Calculations
8. Design Flood Elevation
Underground
Overhead
I
I. Size Service: L"��
2. Conductor Size:
3. a. Meter Main:
b. Meter Can Only: ❑
Gtundin Electrode Conductor Size
46
El #4
C3 #2
n Other
Dual Electrodes r Test Required
❑ CU d -ALUM
CONSTRUCTION TYPE:
Residential
❑
Mobile Home
❑
New Installation
E]
Old Installation
T.1b1d%bJd&_formsNNew ApplicationsWoms%lectrical Riser Plan -doe Rev. 5/29112