HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BECOMPLETED FOR APPLICATION T0BEACCEPTED
Date: Permit Number: 19A
/
V42211111111 I va . IMMMIXIS I saw Building Permit Application
Planning and Development Services .
Building and Code Regulation Division
2300Virginia Avenue, Fort Pierce B34982
Phone: (772)462'1SS3 Fax: (77I)462'1S7D ConOn0erCialResidential
PERMIT TYPE: Electrical
IJ
RM
Address: 250 Palm Breezes Road Fort Pierce, FL, 34945
Property Tax |D#:231O-5O8-0134'OOO'1
Site Plan Name: Owens
Project Name- Owens
Supply and install mechanical interlock with 5Oamp inlet box
Lot No. 1
Block No. 7
Additional worktobeperformed underthispennit—checkaUthutappk,
—Mechanical __GasTank Gas Piping Shutters Windows/Doors
Electric __Plumbing Sprinklers Generator Roof Pitch
'
Total Sq. FtofConstruction: Sq. Ft. ofFirst Floor:
ab
Cost ofConstruction: $ ffisUtilities: __Sewer —Septic Building Height:
AN
77,
Name Daniel Owens
Name: Mike Flaxman
Address: 350 Palm Breezes Road
Company: Energized Electric
City: Fort Pierce State:
Zip Code: 34945 Fax:
Phone No. 772-242-1487
Address:4252 Bandy Blvd
City: Fort Pierce, State - Fl
Zip Code: 34981 Fax: 772-318-6672
Fill in fee si mple Title Holder'on next page if different
from the Owner listed above)
E-Mail.energizedgenerators@gmail.com -
State or County License ec13006279
Ifvalue ofconstruction is $2500ormore, aRECORDED Notice nfCommencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip:
Phone
Not Applicable MORTGAGE COMPANY:
Name:
Address:
State: Citv:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
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 rio 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 coriflict 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 ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of
r as Agent for Owner I Sign
Holder
STATE OF FLORIDA,STATE OF FLORIPA
COUNTY OF CA.�L COUNTY OF
The forgoing instrument was acknowledged before me
this % iayofspD�Z�� ,201C by
- WOP"d TAax"/)(A y)
Name of person making statement.
Personally Known __k'OR Produced Identification
Type of Identification
Produced
(Signature of N ; aryl- fjtabAlq Ej�r I ALVES
MY COMMISSION # GG 232946
Commission No. PIRES:J(&e;2VJ 2022
Bonded Thru Notary Public Underwriters
REVIEWS I FRONT I ZONING
COUNTER REVIEW
RECEIVED
DATE
COMPLETED
The forgoing inst ment was acknowledged before me
this�4VIOay of 201�1 by
Name of person making
statement.
Personally Known
OR Produced Identification
Type of Identification
Produced
,.
ka
(Signature of Notary Pi.r
DANIEL EGONCALVES
Commission No.
_=otrt'YPq�c,,
WCOM���`�I�N#GG232946
EXPIRES: June 27, 2022
Bonded Thru Notaa Public Underwriters
SUPERVISOR PLANS I VEGETATION I SEATURTLE I MANGROVE
REVIEW I REVIEW REVIEW REVIEW REVIEW