HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ® j�
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Building Permit Application
PERMITTiNG
Planning and Development Services St.Lucie Count'.
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
:Address: 6687 Dickenson Terrace Port saint Lucie FL 34952
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Legal Description: Oleander Pines Replat Bilk lot 161
Property Tax ID#: 3415-706-0032-000-3 Lot No.161
Site Plan Name: Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK:
Install Mechanical interlock wioth 50 amp back feed to breaker
>CONSTRUCTION INFORMATION:
. Additional work to e nertormed under this permit-check all apply:
L�HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric ❑Plumbing Sprinklers Generator Roof Roof pitch
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Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2445.00 Utilities:Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameJoseph Cipriano Name: Michale Flaxman
j Address:6687 Dickinson Terrace Company: ENergized Electric
. Port Saint LUcie 645 NW Enterprise Drive#107
;City. State:_ Address:
Zip Code: 34952 Fax: City: Port Saint Lucie State:FL
Phone No.571-274-0436 Zip Code: 34986 Fax: 7728773614
E-Mail: Phone No. 7728773440
Fill in fee simple Title Holder on next page(if different E-Mail: Antonella@Energizedgenerators.com
from the Owner listed above) State or County License: EC13006279
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLE!V( NTAL CONSTRUCTION LIEN.LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
;City: State: City: State:
'Zip: Phone: Zip: . Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
;Address: Address:
City: City:
"Zip: Phone: Zip: Phone:
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.
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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
iimprovements 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 otce of Commencement.
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Signature of 0 ne Less /Contractor as Agent for Owner Signature f C ctor/License Holder
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STATE OF FLORIDA, ` STATE OF FLORIDA
COUNTY OF n� `L�to COUNTY OF S'CC cr1� l,c "e.
The fo going instr ment was acknowledge before me The fo going instrument was acknowledged before me
this X day of 20 Xby this (� day of DecP —hLr 20 &by
ividmell Roffman �Ravwtri
(Name of p rson acknowledging) (Name person acknowledging)
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(Signat a of Notary Public-StatV Florida) (Signature.of Notary Public-Stat f Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificati Produced Type of Identification Produced
Commission No. 4yea� Commission No.
o cG Nota-(Seal). State of Florida 01 Re Notary Public State of Florida
? Antonia M Paula
a hiw rnmmission FF 191201 Antonia M Paula
r^r of�,oe Expires 0 2127/201 9 p
ReVlsed07/15/2014 0 2127/2 01 9
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE _ J
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