HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: Permit Number:
RECEIVED
o
—t----- Building Permit Application BAN 01 'r '
Planning and Development Services ST. Lucie County, Permitting
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
PROPClSED IMPROVEMENT LOCATION -
A
Address: `L4 Ia-L 0I�.
Property'rax ID
Site Plan Name:
Project Name:
Additional work to be performed under this permit- check all that apply:
Mechanical
_
Electric
Gas Tank
Plumbing
_ Gas Piping
_ Sprinklers
_ Shutters
_ Generator
Total Sq. Ft of Construction:: 1 Sq. Ft. of First Floor:
Cost of Construction: Utilities: —Sewer _Septic
Lot No. I I
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE;._
CONTRACT(5R.,
Name
Name: Mike FLaxman
r1 c-`(i
Addre7s-s�"�)�` S dS� .l�
Company: Energized Electric
City: Tt � 17 ➢ State:
Zip Code: 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 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.
SUPPLEMENTAL CONSTRUCTION LIEN IAW INF0RMATCO.N:
,
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 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 BE ORE THE FIRST INSPECTION. IF YOU INTEND TO OBT''A,,,I�NNFINANCING, CONSULT
WITH YOUR LENDER OR AN A; fORNEY BEFORE RECORDING YOUR NOTICE OF�iSMM1lEryccMENT."
of
as Agent for Owner
STATE OF FLOE A STATE & FLO
COUNTY OF COUNTYOF �6
The f_orgping instrulnent was acknowledged before me The for oing ins ment was acknowledged before me
his day of 20�Q by this day of" 2006 by
Name of person making statement. Name of person making statement.
Personally Known X__ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public= State of Florida),
DANIELLE GONCALVES
COMMISSION #GG232ai +'IJCfr;'• DANIELLEGONCALyES
e Commissio ►ry��q", •' SIGN#GG �'
dd Th.,N t.-EXIshi 2.. t'', .��3 ExPIRES:June27,2072
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