HomeMy WebLinkAboutSybert gas appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
J Cv[E_ .
Permit Number:
Building Permit Application
Planning and Deveiopment Services
Building and Code Regulation Division
2300 Virginia R venue, fort Pierce FL 34982
Phone: (772) 4.62-1553 Fax: (772) 462-1578
Commercial
Residential X
PERMIT APPLICATION FOR :Gas disconnect reconnect
PROPOSED IMPROVEMENT LOCATION:
Address: 3213 River Drive Fort Pierce Florida 34981
Property Tax ID #: 2436-562-0061-000-3
Site Plan Name: Sybert Gen
Project fume:
DETAILED DESCRIPTION OF WORK:
Disconnect gas line from exisiting generator reconnect to new generator
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
,Mechanical — Gas Tank Gas Piping Shutters
— Electric , Plumbing `Sprinklers
Total Sq. Ft of Construction:.
Cost of Construction: $ 395.00
OWNER/LESSEE:
Namedune Sybert
Generator
Sq. Ft. of First Floor:
Lot No. 61
Block No.
Windows/Doors Pond
— Roof Pitch
Utilities: _Sewer Septic Building Height:
Address, -3213 River Drive
City: Fort Pierce
State:
Zip Code: 34981 Fax:
Phone No.
E -Mail
Fill in fee simple Title molder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name:Michael Flaxman
Company: Energized Electric
Address:4252 Bandy Blvd
City: Fort Pierce State: FI
Zip Code: 34981 Fax: 772-318-6672—
Phone N0772-466-1095
E-Mailenergizedgenerators cx gmail.com
State or County License LQ45030
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 its required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER
Name:—
Address:
City.
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
:Not Applicable
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 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 inspection. If you intend to obtain financing, consult
with lender or an attorne before co encin work or recordin our Notice of Commencement.
Signature of Owner/
Agent for Owner � Signature
STATE OF FLORID' �
COUNTY OF �}`A� C—
Swo (or affirmed) and subscribed before me of
Ahysical Pre ence or Online Notarization
this ALL—clay of 2020 by
I `Y
Name of person making statement.
Personally Known _kOR Produced Identification
Type of Identification
(Signature of Notary P
DANIELLE GONCALVES
Commission No. ,: :�_ MYCOT191MION#GG 232946
c-J�I ?RES.
June 27, 2022
Bounded Thru Kota
ry Public UndeWte
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Holder
STATE OF FLORI
COUNTY OF L,
orn to (or affirmed) and subscribed before me of
Physical PrE ence or Online Notarization
this LK day of/ 2020 by
G
Name of person making statement.
Personalty Known OR Produced Identification
Type of Identification
Produced
MY COMMISSION # GG 232546 R
C iia No (Seal)
Bond4M 1 hru Notary Public Undenvw j,, s
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW