HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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L7Y- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Gas
PROPOSED IMPROVEMENT LOCATION:
Address: 4499 GATOR TRACE BLVD Fort Pierce, FL 34982
Property Tax ID #t: 2434-804-0002-000-1
Lot No.
Site Plan Name:
Block No.
Project Name: Steven V Barbella Gas
DETAILED ❑ESCRIPTION OF WORK:
A. in nic,ti
V
r
New Electrical Meter Second Electrica) Meter
I
CONSTRUCTION INFORMATION: —
F
Additional work to be peyformed under this permit— check all that apply:
Mechanical �_ Gas Tank _ Gas Piping _ Shutters , Windows/Doors Pond
Electric Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 3,700.00
Sq. Ft. of First Floor:
Utilities: _Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameSteven V Barbella
Name. -Michael Flaxman
Address:4499 GATOR TRACE BLVD
Company: Energized Electric
City: Fort Pierce State: rG-
Zip Code: 34982 Fax:
Phone No.7725289457
Address:4252 Bandy Blvd
City: Fort fierce State: FI
Zip Code: y4981 Fax:
Phone N o 772-466-1 095
E-Mail:steveb-inv@hotmaii.com
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail eneegizedgenerators@gmail.com
State or Ciunty License LQ31756
Val WU U1 Z.ul I btr ULUUn !y z5uu or more, a Ktc.UKUhU Notice of Co m mencemeot is required -
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is eequired.
i
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:_
Address:
City:
Zip:
Phone:
MORTGT COMPANY: Not Applicable
Name:
Address: 1
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
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 Cc u nty 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.
Inconsideration 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 con currency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentia] use
WARNING TO OWNER: Your failure to Record a Notice of Commencgment may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posed on the jobsite Before the first inspection. If you intend to obtain financing, consult
with lender or an a rnev before commencing work or recording you r,Notice Commencement.
Signature a O ner4 essee/Contractor as Agent for Owner
Signature of CAtractrLicense Holder
STATE OF FLORI
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STATE OF FLCIDA
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COUNTY OF A
COUNTY OF : Z,
5 -fo (or affirmed) and subscribed before me of
rf to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
�Physi�al Presence or Online Notarization
this diary of . 2020 by
this d' y of 2020 by
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Name of person making state nt.
Name of person
making statement.
Personally Known - OR Produced Identification
Personally
Known OR Produced Identification
Type of Identification
Type of Identification
P duced
Produced
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5{Signature
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(Signature
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DANIELLEGONCALVES
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_, COMMISSION # GG 294
_
Commission . : - MY COMMISSION#GPW6
Commissio
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:June 27,
EXPIRES: June 27, 2622
"'�
:"'g „p'4 Banded Thru Notary Public Underwriters
or ► p:, Banded Thru Notary Public Underwrriers
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Rev. 5/6/20