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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ) ' as - 'a) Permit Number: I� -- - - --- -- Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE. Generator Address: Property Tax ID #: a"3I q- l 3 q - OOo' 1 ` 0Q'O — Lot No. Site Plan Name: &C O 7 Block No. Project Name: Pi C OS Cs' c� CONSTRUCT,IONINFORIVIATION Additional work to be performed under this permit— check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors �ectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ !Rq ()r) Utilities: _Sewer _Septic Building Height: ©WNER'/LESSEE` lr } CQNTRA{CTOR - ,. Name M ( Name: Mike FLaxman Address: 6 ,�— Company: Energized Electric City: (C* P' ce State: Zip Code: ?Jyq�.. Fax: Phone No. Address:4252 Bandy Blvd City: Fort Pierce State: FL Zip Code: 34981 Fax: 7723186672 Phone No772-466-1095 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 ecl3006279 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. SUP.PLEMENTALCONSTRUCTIQN'L'IEN -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 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 R PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN F NANCING, CONSULT WITH YOUR LEND AN NEY BEFORE RECORDING YOUR NOTICE OF COMMEN ENT." AZ " y Lesse Contractor as Agent for Owner Signature of OIRI Signature of ¢ ractor/Lice se Holder STATE OF FLDA STATE ��,�� COUNTY OF Y OF-,---) COUNTY OF l The r o-ng instr e t was acknowled�,pefore me The forgoing inst ment was acknowledged before me thi ayof2 y this ayof 20�y Name of person making statement. Name of person making statement. Personally Known OR Produced Identification _ Personally Kno2h� OR Produced Identification Type of Identification Type of Identification Produced Produced l ANI Signature rMof ,yib 6iL5UA158$I h i®� 2 (Signature f,r. Y�jJruf�' ��y yJ2Sg6 EXPIRES1:..June27,2022 "*' r„ EXPIRES: June27,2022 `O Commission o:'••...,,,.'�' aondedTbruNo Pubir• Idters �/� Commissio p. AIMaN P�bIIC W�'+� R REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED ' DATE COMPLETED ev.