HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED -FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: ,( -Y •��l
Building Permit'Application APR 2 01 2017
Planning and Development Services
Building and Code Regulation Division PERMITTING
u Lucie County, 2300 Virginia Avenue, Fort Pierce FL 34982 St. FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Generator -j
PROPOSED IMPROVEMENT LOCATION:
Address: 13407 NW Wax Myrtle Trail Palm City FI 34990
Legal Description: Harb. Ridge Palt No 1 lot 4
Property Tax ID #: 443660100040004 Lot No.4
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Serv.'c..t_ 1 �•U�o rYwi•: C.. TewaS.i e 61�d�"
rn c4v I-c
CONSTRUCTION INFORMATION:
Additional work to jbe Dertormed under this permit— check a apply:
E1HVAC L_J Gas Tank Gas Piping Shutters a Windows/Doors
RElectric ElPlumbing Sprinklers W Generator E]Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 9295.00
Sq. Ft. of First Floor:
Utilities:Ll Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
N a m e Jack Tickens
Name: Michael Flaxman
Address:13407 NW Wax Myrtle Trail
Company: Energized Electric
City: Palm City State: _
Zip Code: 34990 Fax: Port Saint ICUie
Phone No.
E-Mail:
Address: 645 NW Enterprise Drive #107
City: Port Saint IUcie State: FL
Zip Code: 34986 Fax: 7728773614
Phone No. 7728773440
Fill in fee simple Title Holder on next page (.if different
from the Owner listed above)
E-Mail: Antonella@Energizedgenerators.com
State or County License: EC13006279
IIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
_Not Applicable
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.
Signature
as
Signature
STATE OF FLO DA STATE OF FLORIIp n
COUNTY OF t,�(,LG V2 COUNTY OF
The for in instru nt wa acknowledged b fore me
this day of Ir 20 acknowledged
(Na
(Signatufe of Notary Public- State/ororida )
Personally Known X2OR Produced Identification
Type of Identificati n Produced
The forgoing instrument was acknowledge efore me
this day of (r' 20 I by
(Name of p on acknowledging )
(Signature of Notary Public- State of rids_)
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. '""� ' �Se�al� Commission No.
1b ,CRY P% Notary Public ca e f Florida
Aniania M Paula 91201
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ExQires 02/27/2019
Revised 07/15/Oa,-,.�,,y�{�.��'
(Seal)
Antoni. .ia
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Expoies 02 7/2019
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
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VEGETATION
V Y iI
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
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INITIALS