HomeMy WebLinkAboutelectric subPLANNING & DEVELOPMENT SERVICES
Building & Code Comptiance Division
BIlll,DlNG PRRMTT
SU B.CONTR,A,CTOR ACR,EEMENT
iAFE Contracting/Modern Electric have agreed to be
i Conrpauy Name/lndividual Namii
16s Electricai Sub-contractor for Northstar General
i1'.vpe olTrade)(Prirnary Coutractor)
h-ur the ploject located ar 7556 S US1
(Projcct Strect Address or propcrry Tax Ib #)
li is uniierstood that, if there is any change of starus regarding our participation with the above mentioned
project, the Building and Code Regulation Division of Sr. Lucie County will be advised pusuanr io the
tiiing of a Change of Sub-contractor notice.
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STAiIIP
l'rint fsnle ol Norary public
.:itr!1ii,,.,,+- EILEEN lltiJlB
joi (t\ i-: MY coMMlssloN # GG 232379
?1i.f;?Sl: EXPIRES:Ausuot12,2022
':;fl',1'l;""' Bond.d l hru l{otary Public Urdenrriters
PATRTOTAPARROTTA f
Commission # HH 0730Ae :
Expires December 10, 2024
Bonded Ihru Eudget NotaryServices
Joshua L Agriesti
ilcr,isetl I l!l612Al6
STAMP
AII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3- Ll - 2dZ2-permit Number: SLC-2107- 0791
Building Permit Application
Planning and Development Services
Building qnd Code Regulotion Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1.553 Fax: (772) 462-L578
Commercial x Residential
CBDG Funding
PERMITAPPLICATION FOR: Erectri-c as per plans
PROPOSED IM PROVEM ENT LOCATION :
Address: 7ss6 S US1
Property Tax lD #:
Site Plan Name:
3422- Bs8-ooo1- ooo/1 Lot No. D1
Prima Vista Crossings Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Convert space back to vanllla Box
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION I N FORMATION :
Additional work to be performed under this permit - check all that apply:
_Mechanical _ Gas Tank _ Gas Piping Shutters Windows/Doors
Roof
Pond
Pitchx Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
lf value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required.
OWNER/LESSEE:CONTRACTOR:
Name
Address:
City:State: _
Zip Code:
Phone No.
Mail:
Fax:
E-
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: .foshua Agriesti
Company: Jafe ContracLing dba Modern Electric
Address: 240 N oixie Highway #18
City: HollYwood State: FL
Zip Code: 33020 Fax:gs+ - gzt-t gl o
phone ry6 954 -92L-6360
E-Mail j osh@j afecontracting. com
State or County License Ec \toot-tgt2-
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION :
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City:State:
Zip:Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Add ress:
City:State:
Zip: _ Phone
FEE SIMPtE TITLE HOLDER: _ Not Applicable
Name:
Ad d ress:
City:
zip:Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
zip:
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 Cqunty makes no representation that is granting a permit will authorize the oermit holder to build the subiect structurewhich conflicts with any applicable Homeowners-Associalioh rules, bvlaws or and coVenants that mav restrict or orohibit suchstructure. Please consult With your Homeowners Association and feview your deed for any restrictioris which may apply.
ln 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
- or - Owner Builder as applicable
STATE OF FLORIDA a - -. r
COUNTY OF i. TCtJ((J.Tq
Sworn to (or affirmed) and subscribed before me of
trris X I aay of fflrtr0h , 2o-Jlhv
Name of person making statement.
Personally Known \' OR Produced ldentification
(Signature of Notary Public- State of Florida)
commission No l{H 0r1608tg (s"rt)
SEA TURTLE
REVIEW
DATE
COMPLETED
Phone:
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. lf you intend to obtain financing, consult
with lender or work or Notice of Commencement.
I Physical Presence or _ Online Notarization
s{1.19'r,^ffi PATRICIAPARROTTA
Commission # HH 073086
Expires December 16, 2024
Eonded Thn BudgetNolary Seillcas