HomeMy WebLinkAboutPermit App 12414 Harbor Ridge Blvd.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/26/21 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: 12414 Harbor Ridge Blvd.
Property Tax ID #: 4426-807-0045-00-4
Site Plan Name:
Project Name: Turner
DETAILED DESCRIPTION OF WORK:
-Add (6) 6" LED recessed cans on dimer switch in kitchen
- Re -locate kitchen light switch to opposite wall
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
(Affidavit required)
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
x Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 1.100
Cost of Construction: $ 2,400.00
Sq. Ft. of First Floor:
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Kathleen Turner
Name: Randy Oliveira
Address: 12414 Harbor Ridge Blvd
City: Palm city State: FL
Zip Code: 34990 Fax:
Phone No. E-
Company: Go Local Electric L.L.C.
Address: 660 SE Monterrey road
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No 772-237-2351
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Info golocalelectric.com
State or County License ER13014996
If value of construction is 2500 or more, a RECORDED Notice of commencement is requires.
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 is in conflict with any applicable Home Owners Association rules, bylaws or an 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Lic Hol
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF Cy\6V }
The forgoing instrument was acknowledged before me
The prgoing instrument was acknowledged before me
this day of 20_ by
this day of �%Ca"J 2Q�) I by
I�c.^al 1 I` 1 r vffrp
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- State of Florida)
Cigna ure of Notary Publi - State of Florida )
Commission No. (Seal)
Commission N .4'''*V `-. DANIELLEZIELINSK�(Seal)
mrntssion # GG 91ffl!
Expires October 13, 2023
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Rev. Z///19