HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit'Number:Q -� 000_Co .
rOv
U CEZIVED..
NOV 3 0 2021
Planning.and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROV,EM.ENT LOCATION:
Address: 10197 Indian River Dr. Fort Pierce FL 34928
Property Tax ID#: 3529-233-0002-000-3 Lot No.
Site Plan Name: Pennell Michael Block No.
Project Name: Pennell Michael
DETAILED.DESCRIPTION OF WORK:.-
Installation of 24kw Generator
New Electrical.Meter Second Electrical Meter (Affidavitll 3M
CO'NSTRUCTI'ON INFORMATION:
i
Additional work to be performed under this permit—check all that apply:
_Mechanical Gas Tank —Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers X Generator _Roof Pitch
Total Sq, Ft of Construction: Sq. Ft.of First Floor:
60
Cost of Construction:$ �, Q�r Utilities: _Sewer _Septic Building Height:
CMN'ER/LESSEE: .CONTRACTOR,:
Name Pennell Michael Name: John J Rack
Address: 10197 Indian River Dr. Company: Rack FlPctric
City: Fort Pierce State: FL -Address: 153 NW 16TH ST
Zip Code: 34928 Fax: city: Boca Raton State:EL_
Phone No. 954-856-6221 E- Zip Code: 33432 Fax:
Mail: mgpennell@comcast.net Phone No 561-391-3550
Fill in fee simple Title Holder on next page(if different E-Mail info@rackelectric.com
from the Owner listed above) State or County License EC13002600
If value of construction is 2506 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW IN FORMATION.":
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:
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 conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Homeowners 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.
Signat r o 0 ner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Florida
Sworn to(or affirmed)and subscribed before me of X Physical Presence or Online Notarization
this 14 day of OCt. 20 21 by
2
Name of person making statement:
TIFFANY TROUT
Person Known ✓/ OR Produced Identification :
t . t, MY COMMISSION#HH 098695
Type o Id ification Produced_ m� :;� EXPIRES:June 29,2025
Bonded Thtu Notary Public Undurtvdtm
(Signature of Notary Public-State of Florida)
Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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