HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 00. 0
Date: Permit Number:
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Building p Permit Application
MON ,
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce F134982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Electrical El
PROPOSED IMPROVEMENT LOCATION:
Address: 9407 Meadowood Dr, Fort Pierce, FL, 34951
Legal Description: MONTE CARLO COUNTRY CLUB-UNIT ONE-LOT 179 (OR 2564-2112)
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Property Tax ID#,: 1327-801-0068-000-0 Lot No.179
Site Plan Name: Van-Buren Block No.
Project Name: Van-Buren
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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Install of a 10kw portable generator with electric start
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CONSTRUCTION INFORMATION:
Aaditional work to be nertormed under this permit—check all apply:
C�HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft.of Construction: S . Ft.of First Floor:
Cost of Construction:$ Utilities:Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Robert Van-Buren Name: Michael Flaxman
Address:9407 Meadowood Dr Company: Energized Electric
Fort Pierce FL
' City: State:_ Address: 645 NW Enterprise Dr, suite 107
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-429-0658 Zip Code: 34986 Fax: 772-877-3614
E-Mail: Phone No. 772-877-3440
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.
-SUPPLEMENTAL 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:
jZip: 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
Cructure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
lin 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 your paying twice for
+improvements 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 our Notice of Commencement.
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iSignature Of 0 ner essee/Contractor as Agent for Owner Signafure okloi1tractorgicense Holder
STATE OF FLORI STATE OF FLORA
COUNTY OF_ Luc l e- COUNTY OF
The JP�rgoing inst me t was acknowledged�before me The forgoing instrument as acknowledg d before me
this LW_.day of r 20 Irby this�day of 20 by
(Na of person acknowledging) ( e of person acknowledg' g)
'� L'// &
( ' n ure of Notary Pu 'c- to of Florida) gnature of Notary P lic tate of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. fission No. (Seal)
a00 Pyp Notary Public State of Floi j1da
Antonia M Paula
my r ra eL�
Revised 07/15/2014 �oFF,u4 Expires 02/27/2019 Antonia M Paula
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NZ' Expires Commission
02/2712 19 191201
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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