HomeMy WebLinkAboutPermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
S`VI LUQL - , .
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Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34952
Phone: (772) 462-1553 Fax. (772) 462-1578
Commercial Residential YES
CBDG Funding
PERMIT APPLICATION FOR: WILLIAMESHLEMAN
PROPOSED IMPROVEMENT LOCATION. -
Address: 1736 PONDBERRY LANE
Property Tax ID #: 3426-703-0162--000-8 Lot No. 148
Site Plan Name: Block No.
Project Name: BILL ESHLEMAN
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING REGULATOR WITH NEW, CONNECT NEW GENERATOR WITH EXISTING
GAS LINE
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank X Gas Piping _ Shutters
(Affidavit required)
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 383.80
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNERAFSSEE:
CONTRACTOR: .�
Name WILLIAM EHSLEMAN
Name: RONNIE KELLAR
Address: 1736 PONDBERRY LANE
Company: EXCEL ELECTRIC LLC
City: PORT ST LUCIE State: FL
Zip Code. 34952 Fax:
Phone No. 772-812-7504 E-
Mail: BILLESHLEMAN@YAHOO.COM
Address: 8241 BUSINESS PARK DR
City: PORT ST LUCIE State: _EL_-
Zip Code: 34952 Fax:
Phone No 772-529-1091
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail EXCELOFFICE77 YAHOO.COM
State or County License LI 45010
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: Not Applicable
Name: _
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip; Phone: _
State:
_ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:
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, wails, 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.
Lu wi County an posted on the jobsite before the first inspection. If you intend to obtain financing, consult
witil lender or/anattor_pey before commencing work or recording our Notice of Commencement.
Signature of Contractor - o -Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF ST LUCIE
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this Lkb day of 20 22 by
1 nai �J �ii I LZ ✓
Name of person making statement.
Personally known X _ OR Produced Identification
Type of Identification Produced
(Signature of N ry Public- State of Florida)
.�fY Notary Pubtzc State of Florida
Commission No. GG 946316 (Seal) Ashley Simlamany
My Commission GG W316
Expires0211612024
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Rev 10/12/21