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HomeMy WebLinkAboutDomicoli elec appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a - p Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: Electrical work PROPOSED IMPROVEMENT LOCATION: Permit Number: Building Permit Application Address: 16 Alhambra S, Port ST Lucie, FL, 34952 Property Tax ID #: 3426-500-0009-000-5 Site Plan Name: Domicoli Project Name: __ .. DETAILED DESCRIPTION OF WORK: Install mechanical interlock and 50 amp plug Commercial Residential X Lot No.16 Block No. 1 & 2 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 Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction. $ 3495.00 Utilities: _ Sewer _ Septic Building Weight: Pitch OWNER/LESSEE: CONTRACTOR: Name Nancy Domicoli Name: Michael Flaxman Address:16 Alhambra S Company: Energized Electric City: Port ST Lucie State: _ Zip Code: 34952 Fax: Phone No.8452208000 Address:4252 Bandy Blvd City: Fort Pierce State: FL Zip Code: 34981 Fax_ 7723186672 Phone No7724661095 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 E:C13006279 it value or consirucaon is :>z5uu 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 Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: BONDING COMPANY: Not Applicable Name: 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 BEFO THE FIRST INSPECTION. IF YOU INTEND O O AIN F ANCING, CONSULT WITH YOUR LEN ER OR AN A NEY BEFORE RECORDING YOUR NOTICE ENC NT.rr Signature of Ow r/ Le see/Contr ctor as Agent for Owner Signature of Contr ctor/Licens Holder STATE OF FLORIDA COUNTY OF%�( STATE OF FLOR COUNTY OF ; 1 �� � The forgoing instru ent was acknowled ed before me The for ping instr e t w s acknowledg before me this ay of 2E by this day of 20 (by flRCL Win � ✓� ?� 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 Wiry- aArJ n J tIL (Sig t tyP& ,lotarROW5 =6 ��orid €.; .� MY commis EON # GG 232946 (Signature o Emit R Iffi$I i019132946 �;��` EXPfRES: June 27, 2©22 Corr "kf. : Y` EXPIRES: June 27, 2022 (S 1) ` °C.... Scnde�T�ru Notary ers Commission Fu�lic °r" Bcn ed T # u Notary Pupfic Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.