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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: — �7- 2.0 Permit Number:
0
RECEIVED
- - - Building Permit Applicati n FEB 19 2020
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division /
2300 Virginia Avenue, Fort Pierce FL 34982 7vC/
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: Generator
PROPOSED IMPROVEMENT LOCATION:
Address: 605 NW Winters Creek Road Palm City FI 34990
Property Tax ID #: 4422-810-0017-000-7
Site Plan Name: Slaysky
Project Name: Slaysky
DETAILED DESCRIPTION OF WORK:
Lot No.7
Block No.
Supply and install 22kw generator with )1) 150 amp and (1) 200 amp service entrance rated transfer switches
CONSTRUCTION INFORMATION':, i
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers ?Generator _ Roof Pitch
Total Sq. Ft of Construction:
11rr11
Cost of Construction: $ lk``'-AgS (�O
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJohn R Slaysky
Name: Mike Flaxman
Address:1176 Lone Pine Woods Drive
Company: Energized Electric
City: Bloomfield Hills State: _
Zip Code: 48302 Fax:
Phone No.
Address:4252 Bandy Blvd
City: Fort Pierce State: FI
Zip Code: 34981 Fax: 7723186672
Phone N0772-466-1095
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail energizedgenerators@gmail.com
State or County License EC1 3006279
IT value of construction Is iZ5DU 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 INFO;RMATTON:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
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 y1NANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICF OF PnmmFNremFNT_"
7
Signature of Owner/ Lessee Coy ra or as /j ent for Owner
Signatur of n actor/Lic nse Holder
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STATE OF FLORID
STATE OF FLOR�Bq 1
i , '
COUNTY OF �'AXUCAe
COUNTYOF �f1� IAJ�4 1
The rgoing instru ent was ac tnowledg d before me
this day of by
The f oingp, i/ntstrupient was acknowled ed before me
thisb�d ofJeMXLYU Z�
1M, IC�Y�1.
���'-1�
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature o I,Q ` .blic-4IeN�n {j fIL ES
MYCoMMISSIONivyJ6
l 232946
(Signature oRM
RES: June 2
CommissionCommission
Pu'Iftlnvnters
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o."+�'��- EXPIRES: t-;Ifc;� Q4Notary
June
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' Sanded Thnr Notary public
Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED