HomeMy WebLinkAboutEC Permit App for 159 NE Estia LaneAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/22/22
Permit Number:
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UPIL °' SBuilding Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 159 NE Estia Lane, Port St. Lucie 34983
Property Tax ID #: 3419-540-0052-000-3 Lot No.
Site Plan Name:
Project Name: Drzal Residence
DETAILED DESCRIPTION OF WORK:
Install new 8/2 to the CU outside from the panel.
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical
X_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ $650
_ Gas Piping
_ Sprinklers
Block No.
_ Shutters _ Windows/Doors _ Pond
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ann Drzal
Name: Michael Pride
Address: 159 NE Estia Lane
Company: Pride Electrical Services of Florida
City: Port St Lucie State: _EL
Zip Code: 34983 Fax:
Phone No. E-
Address: 843 S Kings Hwy. 102-B
City: Fort Pierce State: FL
Zip Code: 34945 Fax: 772-461-2778
Phone No 772-370-8894
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail mike(ftride-electrical.com
State or County License FC13005859 / 29875
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.
AL C
' FORMATION:
DESIGNER/ENGINEER:
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:
State: City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ 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 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 erty. A Notice of Commencement must be recorded in the public records of St.
Lucie County and pos don he jobsite before the first inspection. If you intend to obtain financing, consult
with IE�er'Or-ana non
fore commencing work or rPrnrdino vnur Nntira of rnmmonrpmont
SfinatuFe of Contractor - Owner Builder as applicable
STATE OF FLORIR
Jucie
COUNTY OF 11
Swor or affirmed and��ubscribed bef me of
W
l/ P hysical Presence or _ Online Notarization
this day of by
-- //20
Name of person making statement.
Personally Known OR Produced Identification
Type ntitication Pr uced
(Signs ure of Notary Public- State of Florida)
Commission No. a876!&'02 (Seal)
David Raymond Prue
NOTARY PUBLIC
STATE OF FLORIDA
Coral# GG287052
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