HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, fort Pierce FL 34382
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Generator
Permit Number:
Commercial Residential K
PROPOSED IMPROVEMENT LOCATION:
Address: lilt A) LAJ U -�+C /I DUS I-, CC r -z
Property Tax I D #:��AA`�,Z 6— I Q '" C C C '' 00 0'
Site Plan Name: 6 L,"J.ffn
Project Name:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
rnS�c, I( k;), K
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
_Mechanical _ Gas Tank _ Gas Piping — Shutters Windows/Doors
1
,i Electric _ Plumbing _ Sprinklers — Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ (� t /71
�, 6o
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNERr�AESSEE:
CONTRACTOR:
Name zC0 o1 ee)
Name: Mike FLaxman
Address: /&A,q A)LJ -5o Ib(_)3A d- �Z
Company: Energized Electric
City: 1�j� 4 State-��
Zip Code: t(gCd 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@gmail.com
State or County Ucenseec13006279
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 LAIN 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:
BONDING COMPANY: Not Applicable
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 fuli 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 INTE TO OSTM FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTOI�IEY IAFORE RECORDING YOUR NOTI F MM EMENT."
Signature of Owner/ Lessee/Co ra tar as gent for Owner I Signature of Cr(ntraEtor/Licerfse Holder
STATE OF FLORID STATE OF FLOR : r
COUNTY OF COUNTY OF_ `e "s) C. .
The fqr ping instr me t was acknowle before me
thisday of Zby
I t L ')
Name of person making statement.
Personally Known ` ] OR Produced Identification
Type of Identification
Produced
(Signat e pT,R tb' yPiR� ibt PhZ
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Commis
The for ping instr was acknowledg before me
this ay of 20 ,�by
kLryya n_
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 1 SEA TURTLL MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW ` REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED __