HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/13/2021 Permit Number;
V. LuullE
teCD; `
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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: Meter 'Main and Panel Change
PROPOSED IMPROVEMENT LOCATION:
Address: 6115 Fort Pierce Blvd., Fort Pierce, FL 34951
Property Tax iD #: 1301-605-0289-000-3 Lot No. 23 and 26
Site Plan Name. Lakewood Park Unit 5 Block No. 52
Project Name:
DETAILED DESCRIPTION OF WORK:
Remove inside panel; install 150 amp meter main and 150 amp MLO panel inside;
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: 1276
Cost of Construction: $ 2422
_ Sprinklers — Generator
Sq. Ft. of First Floor: 1276
Roof Pitch
Utilities: —Sewer _Septic Building Height: 1
OWNER/LESSEE:
CONTRACTOR:
Name Jimmy L Vaughn
Name: Donald Green
Company: Bon Green Electric
Address:1305 W 1 st St
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No (772) 418-5739
Address: PO Box 870262
City: Wasilla State: _
Zip Code: 99687 Fax:
Phone No. 907-229-9787
E-Mail: limmyvaughn5310Qgmail.com
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Mall permits@dongreenelectric.com
State or County License EC13007447
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: i
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:
Name:
Address:
City:
Zip: Phone:
—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 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
withlender or an attornev before commencing work or recordinawur Notice of Commencement.
Signioure of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDk
STATE OF FLORIDA
COUNTY OF��a+��
COUNTY OF 8t-0Wacr�/
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _J0 day of DCG . 202p by
Sworn to (or affirmed) and subscribed before me of
)0 Physical Presence or Online Notarization
this jjL� day of �Dr a _ _ _— 202f by
Dar\ Gr4LJ',
Dun &4A^
Name of person making statement.
Name of person making statement.
Personally Known _W OR Produced Identification
Personally Known _%--' OR Produced Identification
Type of Identification
Type of Identification
Produced
Produce
(Signature of Notary Public Sta
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