HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/1/2021 Permit Number:
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V 11TIMP90mil-l!" T-1-- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 760 Silverstream Circle, Lot 8, Fort Pierce, FL 34946
Property Tax ID #: 1433-130-0004-000-1 Lot No.
Site Plan Name: Ridgecrest Mobile Home Park Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Like for Like RV Panel Change
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank —Gas Piping ,Shutters -Windows/Doors _ Pond
_ Electric _ Plumbing
Total Sq. Ft of Construction: 1000
Cost of Construction: $ 2400
_Sprinklers
_ Generator _ Roof Pitch
Sq. Ft. of First Floor: 1000
Utilities: —Sewer —Septic Building Height: 1 story
OWNER/LESSEE:
CONTRACTOR:
Name Ridgecrest Mobile Home Park
Name: Donald Green
Company: Don Green Electric
Address:1305 W 1st St
Address: 300 E Maple Rd. #200
City.. Birmingham State:
Zip Code: 48009 Fax:
City: Fort Pierce State: FL
Phone No. 772-300-6336
Zip Code: 34982 Fax:
Phone No (772) 418-5739
E-Mail:-ridgecrestfla@gmail.com
Fill in fee simple Title Holder on next page ( If different
E-Mail permits@dongreenetectric.com
from the Owner listed above)
State or County License EC13007447
IT Value Of Construction is Z5W or more, a RECORDED Notice of Commencement Is required.
If value of HAVC Is $7,SOO or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ` Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name;
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 PPermit 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 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 yo-urNotice of Commencement.
nat a of Owner/ Lessee/Contractor as Agent for Owner
f Contractor/License Holder
Si =OF
TE OF FLORIDA
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Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this I day of 2020 by
this 1 day of Do-mke. 2020 by
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Name of person making statement_
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of Notary Public- S
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re of Notary Public- S
LAURIE PHILLIPS
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Rev. 5/6/20