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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�r��
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Q1(0 7" 0L
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
P,RQP08 D LIVIPROVEM:ENT•`LOCATI�ON
Address: 8801 One Putt PL., Saint Lucie West, FL 34986
Property Tax ID #: 3334-500-0093-000-8 Lot No.
Site Plan Name: Block No.
Project Name: Installation of 500 gal tank for generator
OETAILED DESCRIPT'IO' OF WORK:
Installation of 500 gal tank for generator
New Electrical Meter Second Electrical Meter
CONSTRUCTIONINFORMATION
Additional work to be performed under this permit —check all that apply:
_Mechanical _�o 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: $ J4010. GO Utilities: _ Sewer- _ Septic Building Height:
01 ' NER/LESSEE , , _
;CONTRACTOR.' • .
Name Keith W Hansen
Name: Jesse Rack
Address: 8801 One Putt PL
City: Saint Lucie Wes State: FL
Zip Code: 34986 Fax:
Phone No.
Company: Rack Electric
Address:153 NW 16th Street
City: Boca Raton State: FL
Zip Code: 33432 Fax:
Phone No 561-391-3550
E-Mail:
Fill in fee simple Title Holder onnext page (if different
from the Owner listed above)
E-Mail INFO@RACKELECTRIC:COM
State or County License LI-45024 / LQ34297
If 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.
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
withI der or attorne before commencin work or recordin our Notice of Commencement.
SUPPLEMENTAL CO:�ISTRUCTION LIEN LAW INFORMAT!•4N
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:
lg�u�rye ,gfd©;wner�/ Lessee/Contractor as Agent for Owner
ntra ' ense Holder
SiaNO
STATE OF FLO
SFLO ID 1
COUNTY OF �rr�
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Sworn to (or affirmed) and subscribed before me of
S o to (or affirmed) and subscribed before me of
Physical Presence or
Online Notarization
Physical Presence or " Online Notarization
thisday of Wu-.,`�
. 202