HomeMy WebLinkAboutJob 7640198 - Electrical Permit Application (Signed).pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/03/2022 Permit Number:
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`" Building Permit Application
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:
PROPOSED IMPROVEMENT LOCATION:
Address: 9009 Pumpkin Ridge, Port St. Lucie, FL 34986
Property Tax ID it: 3322-505-0171-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
- Like for like meter main combo replacement
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 W Shutters _ Windows/Doors _ Pond
X Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: 2,084
Cost of Construction: $
2300.00
_ Generator
Sq. Ft. of First Floor:
Roof Pitch
2,084
Utilities: _ Sewer _ Septic Building Height: 1
OWNERAESSEE:
CONTRACTOR:
Name Matthew Hefflefin er
Address258 Turtle Creek Trail
Name: Donald Green
Company: Don Green Electric
City: Morton State: IL
Address:1305 W 1 st St
Zip Code: 61550 Fax:
City: Fort Pierce State: FL
Phone No. (309) 696-4086
Zip Code: 34982 Fax:
E-Mail:—mheff62@comcast.net
Phone No (772) 418-5739
Fill in fee simple Title Holder on next page ( If different
E-Mail permits@dongreenelectric.com
from the Owner listed above)
State or County License EC13007447
If value of construction is 2SW or more, a RECORDED Notice of Commencement is required.
if value of HAVC Is $7,5W or more, a RECORDED Notice of Commencement Is required.
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Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:__
BONDING COMPANY: ,Not Applicable
Name:T
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 restri tions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, pertorm 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 turke 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 IonAar nr nn %ttnrno hPfnra rnmmanrinv wnrk nr rPrnrriinv vnur NOtIce of Commencement.
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Signatures Owner/ Lessee/Contractor as Agent for Owner
_
Slgnatur Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF a
COUNTY OF —
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or
Online Notarization
x Physical Presence or Online Notarization
this ?Lday of I'IQIr[4+
.2022 by
this day ofILAa✓CZT— 2022 by
Don Green
Dort Green
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of identification
Type of Identification
Produced
Produced
(Signature of Notary Public- Stat
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DATE
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