HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
�z)T
oMlq
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address:
Property Tax ID #:
Site Plan Name:
Commercial
CBDG Funding
Residential
New Electrical Meter Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank
Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
_Gas Piping
_Sprinklers
Lot No.
Block No.
Shutters
Windows/Doors _Pond
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: Sewer _Septic Building Height:
Name �� ��Lke�h
City: qState:
Zip Code: �)C1�1 a
Phone No. 2J�l "1��E-
Mail:�\ Nkk -`Fi �C b&yyary Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Company: ^^� C ��
Address: ��C ,nc\v )`jam, \G. \2 r�
City:l.� flti4 �h State: PL
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Zip Code: 1 Fax:��\
Phone No ��� �1 6 `fi IFS L�
State or County License e[? \vac)
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 CON
Name: _
Address:
City:
Zip:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
N LIEN LAW INFORMATION:
Not Applicable
Name:
may; State:
Phone:
Not App ' able I JkUI%JWIr*Jk3 COMPANY: _Not Applicable
City:
Phone:
OWNER/ CONTRALTO FFIDVIT: Application is hereby made to obtain a permit do the work and installation as indicated.
I certify that no work9r 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 in to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
or -Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF �,YP\Inr�
Sworn to (or affirmed) and subscribed before me of Physical Presence or —Online Notarization
this L day of 202t by
Name of person making statement.
Personally Known K OR Produced Identification
Type of Identification Produced
(�natdre of Notary Pubnc- StJte or rio
commission No. \Et3yU3 (Seap
REVIEWS I FRONT I ZONING
COUNTER REVIEW
Notary Publle Stale of Florida
Stephanie Young
My Commission
I
p HH 133443
Exp.1013012025
SUPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW
SEA TURTLE I MANGROVE
REVIEW REVIEW
1430 Culver Dr NE
Palm Bay,Florida 32907
3217337972
slpedretti@ d rhorton.com
7790 Industrial Road
West Melbourne, FL 32904
321-768-0814 Phone
321-725-5273Fax
www.brevardelectricians.com
EC 13009389
DATE:
ESTIMATOR:
12/1/2021
Corey Russell
PROJECT SPECIFICATIONS
9191 Okeechobee Road Per 2017 NEC, 7th Edition Florida
Building Code
SCOPE OF WORK: Electrical
1. Provide, wire and install one(1) 110V15A dedicated circuit for P482-31 post light with photocell on P5391-
31 post. Circuit to be installed on a 15A QO breaker. Pull power from service panel and flex directly into
fountain control box. Junction inside of fountain control box and run power through existing conduit and
hand hole. From hand hole, trench to post light location and run #14 THHN in 3/4" PVC. Install post and
light with photocell in front of entrance sign. Trench needs to be at least 18-24" deep and backfill once
$ 750.00
complete.
2. ***Permit Fees TBD*** $ 0.00
-Price does not include the cost of permitting. Permit fees will be added to the proposal total at no additional markup
upon receipt of charges from building department.
-Price is based on one (1) trip to complete all work. Additional trips necessitated by customer provided materials not
being on site at time of work completion will incur an additional charge of $125 per occurrence.
-Drywall, stucco, soffit, or landscape repairs [if any] are the responsibility of the customer. Every effort will be made
to mitigate damage to the home. However: Due to the nature of the work being performed a small amount of
damage may be unavoidable.
-For liability reasons, Peay's employees will not move items of monetary or personal value to gain access to locations
where work is to occur. Please have all areas where electricians will need to gain access free of any items of like or
dissimilar nature to avoid delays in project completion.
WARRANTY: All Peay's provided materials and labor are warrantied for one year from installation excluding bulbs and
batteries
Total Sum Of: $ 750.00
CONDITIONS
It is understood and agreed that we shall not be held liable for any loss, damage or delays occasioned by fire, strikes or
material stolen after delivery upon premises, lockouts, acts of God, or the public enemy, accidents, boycotts, material
shortages, disturbed labor conditions, delayed delivery of materials from Seller's suppliers, force majeure, inclement
weather, floods, freight embargoes, causes incident to national emergencies, war, or other causes beyond the reasonable
control of Seller, whether of like or different character, or other causes beyond his control. Prices quoted in this contract
are based upon present prices and upon condition that the proposal will be accepted within thirty days. Also, general
conditions which are standard for specialty contractors in the construction industry.
Payments to be made
TERMS:
50% Upon Acceptance of Proposal 50%+ Permitting Fees
Upon Completion of Work ---- — — — —
To the value of 100 % of all work completed. The entire amount of contract to be paid at completion via cash, check or
money order in full at time of completion.
SUBMITTED Corey Russell
by Gorey Rv'&3 L
ACCEPTED
by
a Pedretti