HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I
Permit Number.
gza Lucas
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982 _7_
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Gas
PROPOSED IMPROVEMENT LOCATION:
Address: 1910 York CfFort Pierce, FL 34982
Property Tax ID #: 2421-603-0006-000-2
Site Plan Name.
Project Name: Patricia Gas
DETAILED DESCRIPTION OF WORK -
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed
Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
under this.permit— check all that apply:
Gas Piping Shutte s
Sprinklers Generator
Sq. Ft. of Fir t Floor:
Lot No.
Block No.
Windows/Doors Pond
Roof Pitch
Cost of Construction: $ C7 p Utilities: —Sew —septic
OWNER�LESSEE: CONTRACTOR:
Namesmith Patricia
Address:1910 York Ct
City: Fort Pierce
Zip Code: 34982
Phone No.7729794801
E-Mail.trtlpats328@aol.com
Fax:
State: rZ-
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:Michael Flaxman
Building height:
Company: Energized Electric
Address:4252 Bandy Blvd
City: Fort pierce
Zip Cade: 34981 Fax:
Phone No 772. 466-1095
E-Mailenerlizedgenerators@gmaii.com
State or Cou my LicenseL-Q31756
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
State: FI
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATI9N:
DESIGNER/ENGINEER: Not Applicable MORTG E COMPANY:
Name; Name:
Address:
Address:
City: State; City:
Zip; Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER
Name:
Address:
city:
zip: Phone:
Not Applicable BONDING COMPANY:
Not Applicable
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 permit.
w 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 applicabie 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 Qounty Amendments.
The following building permit applications are exempt from undergoing a full c ,currency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and a c�ssory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commenc rrlent 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 posted on the jobsite before the first inspectian. If you intend to obtain financing, consult
with lender or an atorneyjofore com mencing work or recordin our Notice of mencement.
Signature of"er/
r as Agent for Owner Signature grCphtractorAtcense Holder
STATE O OF ORI � - STATE OF! F1.ORI❑
COUNTY�r COUNTY
Sw o to (or affirmed) and subscribed Before me of
7d Physical Pre ,en ce or Online Notarization
this day of 2020 by
cki -
Name of person making statement. `
Personally Known '~ OR Produced Identification
Type of Identification
(Sign atur f Pubi
SAY COMMISSION # 5
Co m mi ss io .q ` EXPIRES,. June 27, ���
r.-..
:E of F�,,• on ry Public U
SwO to (Qr affirmed) and subscribed before me of
Physical Pre ence or Online Notarization
this � da f 2020 by
�(Li
Name of pe s I
in making statement.
Personally Known .,\ OR Produced Identification
Type of Identification
REVIEWS COUNTER ZONIREVING
S REVIEW ERVISOR I PLANS
REVIEW
DATE
RECEIVED
DATE
COMPLETED
EXPIRES: ,lime 27, 2022
t IJ ETATI
REVIEW
❑N
SEA TURTLE
REVIEW
MANGROVE
REVIEW