HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
0
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: enerator
Permit Number:
Commercial Residential
PROPOSE
LD
� IMPROVEMENT LOCATION:
Address: /I �f I A)..C` kWe".-4 ��.J�e-��a� (�,�rr,�P �-IM-��-�./ FG 34/cr'*25
Property Tax ID #: 'Na 6 p 0q— 60'w— bad — �z 4 Lot No..�
Site Plan Name: Than"wk i (" tf(1'e Block No.
Project Name:
I DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Me anical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
lectric _ Plumbing _ Sprinklers e Generator _ _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ ._ q/ 6 qs ` 0<�
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWN ERAESSEE:
CONTRACTOR:
Name_ 61(,en `]rfti[35a
Name: Mike FLaxman
Address: i Ah,) (, ec--4 Lw -l&
Company: Energized Electric
city: PA[; State: _L -C
Zip Code: �Q_ Fax:
Phone No.
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 7723186672
Phone No 772-466-1095
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail energizedgenerators@gmaii.com
State or County License ec13006279
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 pians, 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 SYE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO O TAIN FINANCING, CONSULT
WITH YOUR LENDER OF AN ATTORNEY BEFORE RECORDING YOUR NOTIFE OF C ENCEMENT."
Signature of Own r/ Lessee/Clontractcr as Agent for Owner I Signature oytoy(ractor icense Holder
STATE OF FL6RSTATE OF FLORI � n �
'
COUNTY OF ,� __ COUNTY OF a Ij lai
TheXoNay
ing instrunRe-rit s acknowledg d before me
tof t w � ZQ by
hisK(A.�Nl(,C_ IP
Name of person making statement.
Personally Known � R Produced Identification
Type of Identification
Produced
(Sig
!EYP', I}EINIELLE G
Com i �j My COh1MISSION # GG 23294 Se
,w• :,:Xp1RtS.juaa27,2022
bonded Thru Not Public Underwriters
Ther on
instr m mt was acknowled before me
this ' lc" of 2QAby
Name of person making statement.
Personally Known v OR Produced Identification
Type of Identification
Produced
o t a rf)RM O[LT 6bifte& r i d;
MY COMMISSION # GG 232948
EXPIRES: June 27, 21122
Bended Thru Notary Public Undeiwr 4ers
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED