HomeMy WebLinkAboutElectrical Permit - S&W Electric 15200 Orange Ave Ext Tolson ResAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/24/2022 Permit Number:
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Agriculture Exempt 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 Commercial X Residential
IT TYPE:
PERM Electrical i
PROPOSED IMPROVEMENT LOCATION:
Address: 15200 ORANGE AV EXT
Property Tax ID #: 2307-233-0010-000-7 Lot No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Repair and rebuild existing service on pole
CONSTRUCTION INFORMATION:
Utilities: _Sewer _Septic Sq. Ft. of First Floor:
Cost of Construction: $ 1,500.00 Total Sq. Ft of Construction:
FLOODPLAIN DEVELOPMENT PERMIT for structures exempt from Building Code that are in the
floodplain:
Nonresidential Farm Building: Temp. Bldg./Shed used exclusively for construction
Mobile/Modular for temp. construction office: Bldg. involved in distrib. of electricity:
Other: Flood Zone: BFE: Floodway? Y/N If Y,
No Rise Certificate with supporting data attached? Y/N
All other applicable state and federal permits shall be obtained prior to commencement of
construction.
OWNER/LESSEE:
CONTRACTOR:
Name Bryan Odell Tolson
Name: Daniel Stubbs
Address:15200 ORANGE AV EXT
Company:S&W Electric, Inc
City: Fort Pierce State:
Zip Code: 34945 Fax:
Address:501 W Coker Road
City: Fort Pierce State:
Phone No. 772-201-7316
Zip Code: 34945 Fax:
Phone No772-464-6466
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mailjessicastubbs.swelectric@gmail.com
State or County License EC1 3007544
from the Owner listed above)
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: 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 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 our Notice of Commencement.
I
signature of wner/ Les ee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF E�+ L�i C
Sworn tg- or affirmed) and subscribed before me of Physical Presence or Online Notarization
this, c /" ay of 20��by
l) C ��� <. I J% L.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
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(Signature of tary Public- State of Florida )
Commission No. �--• _:)S17(Seal) ,rsr Notary Public State of Florida
Ginger P Hester
My Commission GG 330259
ExpiresM2512023
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