HomeMy WebLinkAboutMcNealy gas appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
91T.
o _ , >, D p
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 207 Essex Dr Fort Pierce, FL 34946
Property Tax I D #: 1432-805-0102-000-6
Site Plan Name:
Project Name: MCNEALY GAS
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
Additional work to be performed under this
–permit– check all that apply:
_Mechanical _Gas Tank z\Gas Piping _Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Residential X
Lot No. 102
Block No.
W
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
I.
Name -Michael Flaxman
Address: 257'Essex
Dr
Company: Energized Electric
City: Fort Pierce State:
Zip Code: 34946 Fax:
Phone No.
-Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax:
Phone No 7724661095
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 LQ31756
It value of construction is Z500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
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 paying twice for
improvements to your pro -orty. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posteo,,6n the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attg6ey before commencing work or recording your Notice of Commencement.
Signature of O ner(/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE diL6111 STATE OF FLORIDA
COUNTCOUNTY OF �)
SwVrn to (or affirmed) and subscribed before me of
�`> P ysical Presence or Online Notarization
this day of 0 r" 1-2020 by
am�N a of person making statement.
Personally KnownOR Produced Identification
Type of Identification
ature of Notary
DANIELL GoNCALVES
Commission No. MyOt�I( fly ION #00232946
EXPIRES' Java 27,2o22.
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Syfsralto (or affirmed) and subscribed before me of
\.P, sical Pre, }ce or Online Notarization
thi ay of7i 2020 by
Name of person making statement.
Personally Known .>c ---OR Produced Identification
Type of Identification
Pr ced
A DIEGO 14fS :
(Signatu `�f taf u � M:HcTd p )
'.91�.... •PCS.'
•.,oKY�.• Bonded Thru Notary Public Underwriters
Commis
SUPERVISORPLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW