HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1
RECEIVED
�COUNTY JUN 25 2019
- Building Permit Applicatioit
ST. Lucie County, Permitting
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 COm'merCial Residential X
PERMIT TYPE:Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 2701 Bent Pine Dr, Fort Pierce, FL, 34981
Property Tax ID#: 1334-502-0015-000-8 Lot No.98
Site Plan Name: Shawn Murray Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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��CTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Pipirig _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: _Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameShawn Murray Name:Michael Flaxman
Address:2701 Bent Pine Dr Company:Energized Electric
City: Fort Pierce State: Address:4252 Bandy Blvd
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.914-456-1322 Zip Code: 34981 Fax: 7723186672
E-Mail:LFDFF20@gmail.com Phone N07724661095
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 EC1 3006279
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. \ `
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATT RNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEM "
Signature 6f O er Lessee/ ntractor as Agent for Owner Signature of C t ctor/Lice a Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF W. Lyci P COUNTY OF SI-• LUe @
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 24 day of Tjbnt 20 19 by this 2�—day of -16 %c 20J I by
M Ickiaef PQY.Mn tAmkgel Act Wctn
Name of person making statement. Name of person making statement.
Personally Known �4 OR Produced Identification Personally Known�_OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of Notary Public a.Qf - ignature of Notary Public-St to of Florida
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Commission No. f96 e + c a OLE AP TE
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EXPIIti�$May 04,2020 e Nk COMUISSION# 3039
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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