HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 x
PERMIT APPLICATION FOR: Generator I
Address: 12083 S INDIAN RIVER DR
Legal Description: FEES S/D S 1/2 OF LOT 11 AND N 1/2 OF LOT 12 WITH RIP RTS (OR 1145-1314)
Property Tax ID #: 4504-602-0011-000-7
Lot No.
Site Plan Name: Block No.
Project Name: Slater, Sally
Setbacks Front, Back: Right Side: �r Left Side: 1
Supply and Install a 20KW Diesel Generator with (1) 200amp Automatic Transfer Switch
❑ H VAC
❑✓_ Electric
mat apply:
_ Shutters
❑ Plumbing Sprinklers 11 Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: 1624
Cost of Construction: $ 25480.00
Name Sharon Evinrude
Address: 12075 S Indian River Dr
Sq. of First Floor: _
Utilities: L_I Sewer E Septic
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Sam Crane
aWindows/Doors
Building Height:
Company: Sam Crane Electrical LLC
Address: 2618 SE Market Place
City: Stuart
Zip Code: 34997 Fax: _
Phone No. 772-223-8865
E-Mail: info@alwaysreadygen.com
State or County License: EC0001986
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
State: FL
NER/ENGINEER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: — Phone:
Not Applicable
te:
Not Applicable
I certify that no work or installation has commenced prior to the issuance of a permit.
ie
wh ch is inconflictwith anyapplicableappli able representation
at is Owners Assscng a ationi rules, es,ill authorize by bylaws or andcovenantsholthaer t may estrictthe borproh bit 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
Signature of Owner se Elcontractor as Agent for Owner Signature of Contractor/License H der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFCOUNTY OF ,j t
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 Eby thisiJ day of ..5k') Ir4 20 , by
(Name of person acknowledging) (Name of person acknowledging )
J
(Signature of Notary Public- State of Florida) (Signature of �Nota9ry`Publli'c'-_S�tate�.,of Florida )
Personally Known ' OR Produced Identification Personally Known ?40 OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. Commission No. _
o�ko'JP�,,, KASSI WILSON `"pVR''/ KASSI WILSON
�r- Notary Public -State of Florida �a°`P �e�= Notar Public-S at
`* *= Commission G 93883 -*
My Commission Expires aPc Commission # GG 938839
Revised 07/15/ f�ui���`� December 11, 2023 %p;orF�a My Commission Expires
December 11, 2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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