HomeMy WebLinkAboutCarpenter appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO HE ACCEPTED
Date:
Permit Number:
--- Building Permit Application
Planning and Development Seryices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: enerator
PROPOSED IMPROVEMENT LOCATION:
Address: ��� 6 A [ ,<AN6 c'c. L` ; (`C- Fay ?tffCe A6 � `t�/
1 9 o�
Property Tax ID 4: 3 LI 16 4tvo d Lot No.,
Site Plan Name: C - --- -- Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
S e-) `n i 1 I.J 4 or t,., �` �� D r �f"
CONSTRUCTION INFORMATION:
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: Sq. Ft. of First Floor:
Cost of Construction: $ } VLI� Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name he 8 (�Arpceif
Name: Mike FLaxman
-<I+
Address: eri'0. 6 or ele
Company: Energized Electric
City: rO r -: -er'c -e State:
` F Fax:
Zip Code: 3_ C{
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 License ec13G06279
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE BOLDER: 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 al} 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�R��°:THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEND ElUrOReAN_ATTCA NEY BEFORE RECORDING YOUR NOTICE I COM14EPiCEMENT." -,,-
Rev. 2///19
Signature of Own / ssee/Con actor as Agent for Owner
Signature of Coract r/License Hol er
STATE OF FLORIDA `
STATE OF FLORIDA
COUNTY OF V'�J
COUNTY OF_ -A
The going instr Hent was acknowledSefore me
�`
The foAoing instr ment was acknowled before me
Pyw 6y
this�ay of 20 L y
this ay of 11 20
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Tame of person making statement.
dame of person making statement.
Personally Known _**< OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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EXPIRES: lune 27,2022
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EXPIRE&: ,lune 27.2022
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REVIEWS
FRONT
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SUPERVISOR
PLANS VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2///19