HomeMy WebLinkAboutBuilding Permit Application 221142-2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05/13/2021 Permit Number:
Gj L O V� LI L tz
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 15601 W Midway Road Fort Pierce 34945
Property Tax ID #: 3201-133-0005-000-0 Lot No.
Site Plan Name: n/a Block No.
Project Name: 100kVA UPS Replacement at EOC
DETAILED DESCRIPTION OF WORK:
replace existing eaton/Powerware 100kVA UPS with new Toshiba G9000 Series 100kVA UPS system
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 78,388.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name St Lucie County
Name: Richard K. Kuzmick
Address: 2300 Virginia Ave
Company: Computer Power Systems
City: Fort Pierce State: FL
Zip Code: 34982 Fax: n/a
Phone No. n/a
Address: 3421 State Road 419
City: Winter Springs State: FL
Zip Code: 32708 Fax: 407 327 7333
Phone No 407 327 7373
E-Mail sarahh@cpsfl.com
E-Mail: n/a
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License `' C 13 U<) i I0-,a-
It value of construction is 2500 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
MORTGAGE COMPANY: V Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: V Not Applicable
BONDING COMPANY: VNot Applicable
Name:
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 property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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.
Si ature of Owner es ee ntractor as Age r Owner
Sig a ure of Con t r/License Holder
STATE OF FLORIDA
COUNTY OF Semird(1—
STATE OF FLORIDA
COUNTY OF Seminole
yrSw n to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this _j2_ day of ry-O V 2020 by
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 12 day of May 202� by
Richard K. Kuzmick
Name of person makii tatement.
Name of person making statement.
Personally Known OR Produced Identification
"d
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
49_AL�2_4 9
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i ature of Nof#y Public- State of Florida)
Commission No. w ( I
o ry Public State of FI
Lesley Rubio
"'(" nature of fyo�tary Public- State FI Notary public State of
�VJI/��"�!!��� C, Lesley Rubio
o ission No. GG 29550 1 M� �i@al Cornnllasibn GG 2
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ev. 5/6/20