HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: FIN.
Building Permit Application RECEivr
Planning and Development Services
PR
Building and Code Regulation Division ap�
2300 Vir inia Avenue Fort Pierce FL 34982
9 �
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentig,XL
PERMIT APPLICATION FOR: Generator -!
I PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name:
Setbacks Front Back:
2
Right Side: Left Side:
Lot No. 1
Block No.
I DETAILED DESCRIPTION OF WORK: I
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CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit — check a apply:
,F—HVAC f Gas Tank ❑Gas Piping Shutters ❑. Windows/Doors
Electric F] Plumbing Sprinklers Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1014157 O Utilities:nSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Michael Flaxman
Company: Energized Electric
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Address• a �' 1 �ci
InnKW
City: State:
Zip Code: Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Address: 645 NW ENterprise drive #107
City: Port Saint Lucie State: FL
Zip Code: 34986 Fax: 7728773614
Phone No. 7728773440
E-Mail: Antonella@Energizedgenerators.com
State or County License: EC13006279
It value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.
•
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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.
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 vour Notice of Commencement.
Signatur6of QWn9f/Lessep//Contractor as Agent for Owner I Signature
STATE OF FLORIDA' I STATE OF FLORIDA
COUNTY OF 5CCiy1 - L.lC l`e COUNTY OF R-A- UkLOQ
The ing instru nt as acknowledge efore me
o o
this day of Vl 20 �by
k
(Na e f person acknowledging
(Signature of Notary Public- St to of Florida )
Personally Known OR Produced Identification
Type of Identificatioh Produced
Commission No.
NOWY Public Sta.W of Florida
r 1 IK v Nly Camrnia�ipn FF 1
Revised 07/15/2014atlF�o ExPirds 02127/2019%
The forgoing ins
tr ment was acknowledge before me
this �' day of '1 20 by
(Nam of person acknowledging)
(Signature of Notary Public- St6te of r1oricia )
Personally Known OR Produced Identification
Type of Identification Prodj-pii
Commission No. c�svr.yn °'(S'eal) «-l9orida
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