HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll 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
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ELECTRICAL
PROPOSED IMPROVEMENT LOCATION:
AririracS 925 JACKSON WAY
Property Tax ID #: 1423-802-0030-000-3
Site Plan Name:
Project Name: DANE DEL PEZZO
Residential YES
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING 200AMP MAIN LUG PANEL WITH NEW 200AMP MAIN LUG PANEL
New Electrical Meter Second Electrical Meter
Lot No.
Block No.
I CONSTRUCTION INFORMATION: .1
Additional work to be performed under this permit —check all that apply:
Mechanical — Gas Tank ^ Gas Piping _ Shutters Windows/Doors
X Electric Plumbing _ Sprinklers —Generator _ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 2977.13 Utilities: —Sewer _Septic
Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name DANE DEL PEZZO
Name: GEORGE G SANCHEZ JR
Address: 925 JACKSON WAY
Company: EXCEL ELECTRIC LLC
City: FT PIERCE State:
Zip Code: 34949 Fax:
Phone No. 772-480-5002
Address:8241 BUSINESS PARK DR
City: PORT ST LUCIE State: FL
Zip Code: 34952 Fax:
phone No 772-529-1091
E--Mail: WAHOORAY@HOTMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail EXCELOFFICE77@GMAIL.COM
State or County License EC-13006483
If value of construction is 2500 or more, a Kk _QKutu notice Or Lommencemem is rVquut:u.
If value Of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Y Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Nat 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 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 recorde ublic records of St.
Lucie County and posted on the jobsite before the first inspection. If you . nd to o in financing, consult
with lanrlar nr an attnrnpv hPfnrP rnmmenring work or recordine v otce of mmencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLOR A
STATE OF FLORIDA
COUNTY OF ,
COUNTY OF 87LUCIE
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
'-�hysical Presence or Online Notarization
_3
X Ph sical Presence or Online Notarization
2021 by
this day of (_i?.iIF� t � 2021 by
this e��day of ,
n - y -
GEORGE G SANCHEZ JR
Name of person making statement.
Name of person making statement_
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produc d li
Produc
ignature of Not
(Signature of Notary Public
��►� Notary Public State of FloridaV�Y
Notary Public State of Florida
A�mlamany
Commission No. Ashiey(SeHl�man y
Commission Na. i M scion GG 946316
i_4�
y * My Commission GG W316
''taw Expires 021161202a
Expirts D211612024
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Rev. 5/b/20