HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/18/2022 Permit Number:
L- �-! CUL
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A Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding _
PERMIT APPLICATION FOR: ELECTRICAL
PROPOSED IMPROVEMENT LOCATION:
Address: 3120 N A1A, Fort Pierce, FL 34949
Property Tax ID #. 1425-610-000-000-0 Lot No.
Site Plan Name: TIARA TOWER CONDOMINIUM ASSOCIATION, INC Block No.
Project Name: TIARA TOWER
DETAILED DESCRIPTION OF WORK:
General electrial repairs in the elevator machine room to also including mini split
system in machine room as a sub -permit through Austen Air Conditioning} Inc. _
New Electrical Meter _ Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
X Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
X Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 23,464.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TIARA TOWER CONDOMINIUM ASSOCIATION, INC
Name: JC Shawn Crow
Address: 825 20th Place
Company: Austen Electric, Inc
City:_ Vero Beach State: FL
Zip Code: 32960 Fax:
Phone No. 772-569-9853 E-
Address: 6200 W 21 Court _
City: Hialeah State: FL
Zip Code: 33016 Fax: 305-805-8190
Phone No 305-805-8166
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Perm ittingCcDaustenelectric.corn
State or County License EC13001529
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: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name: _
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: 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 our Notice of Commencement.
ev
Si ature of Contractor - or -Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of d'`� Physical Presence or Online Notarization
this 20 day of 2021 by
cDecember
�C S h Ci�l
�Wn c.J
Name of person making statement.
Personally Known %� OR Produced Identification
Type of Identification Produced
(Signat of Notary Public- State of Florida)
MICHAELIA DE JESUS
Commission No. }�iN D, R-119 3 (Seal)
Notar,�Public•StateofFloridaPl`CommissionkHH052763
;oF,r�,.°My Comm. Expires Oct 12, 2024
Bonded through National Notary Assn.
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