HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 13 12 0 71 Permit Number:
S'LLLI CLL
�V Building PP 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:Electrical Service Change
PROPOSED IMPROVEMENT LOCATION:
Address: 5024 Watersong Way
Property Tax ID n: 2532-500-0084-000-7
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace exisiting 200amp meter can to a 200amp meter main.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Lot No. 70
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
VElectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Harbey Cecil Eads Jr
Name: John Cavnar
Address: 5024 Watersing Way
Company: Goldstar Electric, Inc.
City: Fort Pierce State: FL
Zip Code:34949 Fax:
Phone No. E-
Address: 213 NE Sagamore Terrace
City: Port Saint Lucie State: FL
Zip Code: 34983 Fax:
Phone No 772-380-5913
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail johns@goldstar-electric.com
State or County License 23575
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
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 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 your Notice of Commencement.
S' ature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORID
COUNTY OF 5 •
Sworn to (or affirmed) and subscribed before me of ✓ Physical Presence or Online Notarization
_
this 3 day of NO V O_rA VVY . 20ZL by
Zahn (ravhn.f
Name of person making statement.
Personally Known _\_Z__ OR Produced Identification
Type of Identification Produced
(fignature of Notary Public- State of Florida)
Commission No. Q (g3 ba?) (Seal) �,r.. N., Pied ea store of Fxxma
Paola Bautista Garcia
�j My Ca 15sim HH 063683
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev 5/ZU/11