HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1
Date: Permit Number: ` V
� , -- RECEIVED
Building Permit Application AUG 0 6 2018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Electrical j
PROPOSED.IMPROVEMENT LOCATION:
Address: 5409 Cassia Dr
Legal Description: I.R,E.S/D Unit 9
Property Tax ID#: 3402-610-0102-000-1 Lot No.19
Site Plan Name: Block No. 73
Project Name: Dean
Setbacks Front Back: Right Side: Left Side:
FDETAILED DESCRIPTION OF WORK:
Install Mechanical Interlock
CONSTRUCTION INFORMATION:
Additional,worKtobenertormedunder this permit—checK a appy:
11HVAC 11 Gas Tank Gas Piping _Shutters Q Windows/Doors
R]Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ -Iy� Utilities,
�Sewer Septic Building Height:
„OWNER/LESSEE: CONTRACTOR: .
Name George&Kimberley Dean Name: Michael Flaxman
Address:5409 Cassia Dr Company: Energized Electric
City: Fort Pierce State: FL Address: 4252 Bandy Blvd
Zip Code: 34982 Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34981 Fax: 772-318-6672
E-Mail: Phone No. 772-466-1095
Fill in fee simple Title Holder on next page(if different E-Mail: EnergizedGenerators@gmail.com
from the Owner listed above) State or County License: EC13006279
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION.:LIEN LAW CNFORMATIOW.
. .
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
N am e:George&Kimberley Dean N am e:Michael Raman
Address:5409 Cassia Dr Address: 54o9 Cassia Dr
City: Fort Pierce State: City: Fort Pierce State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Ad d cess:4252 Bandy Blvd 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 your paying twice for
improvements to your property.A Notice of Commencement must be recorded 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 recor&g your Notice of Commencement.
r �
Signature of ne essee/Contractor as Agent for Owner Signature of Cbry(raaelLicense Holder
STATE OF FLORIDA Luc,1
STATE OF FLORID
COUNTY OF c 31 P., COUNTY OF c , �(P�
The f r oing instrument was acknowledg d before me The forgoing ins r ent was acknowledged before me
this day of � .20 by thi day of 20�by
H�cinckeo (A,\i 11 Fi9
Name of per roaking statement :� Name of pers n aking statement
Personally KnownOR Produced Identificati % ersonally Known OR Produced IdentificationType of Identification y pe of Identification Pr duced 33 3_< roduced 03o (!�10TD O �j 13(Signatur of Notary Public-State of Florida) c� > (Sign t e of Notary Public-State of Florida}m� 7C Commission No. (Seal) N'0 w<= Commission No. (Seal)ao v co
D CO
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17