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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 0 e� ° Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Commercial CBDG Funding Residential PROPOSED IMPROVEMENT LOCATION: ` Address: �� J 1 Y�`a. ooie..- `ic s 1 sifynsy . (a Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: k DETAILED DESCRIPTION OF WORK: 1 New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: _M�Chanical _ 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: $ J s Utilities: —Sewer _Septic Building Height: OWNERAESSEE: CONTRACTOR: Name Uqcic, Name: Address: T Company: Q-A-) Address: �- Q & V " City: ._._ Zip Code: Fax: Phone No.�,�' SLQ (�f�--� _ Stater- E- -- city: r State: L. Zip Code: v��I Fax: Phone No -)1-AA- LA -A C)q S' E-Mail F_ �%L)fCAN-zyd of vurcf State or County License ,._._ Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) 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 Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: _ Address: City: Zip: Phone: MORTGAGE COMPANY: Name: Address: City: Zip: Phone: BONDING COMPANY: Name: Address: City: Zip: Phone: Not Applicable State: Not Applicable 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 t obsite before the first inspection. If you intend to obtain financing, consult with lender or a a t me re commencing work or recording our Notice of Commencement Signature of Contr ctor - fOwner Builder as applicable STATE OF FLOn COUNTY OF E Sworn to (or affirm, �! ��nd�, before me of © Physical Presence or Online Notarization �subscribed this � day of �f 20 Ay Ric Pc®�0 ra�l1�� t—eT Name of person makZOR Personally Known Produced Identification Ty4akof Identification Produced (Signature of Notary Public- Sta e of Florida) Commission No. (Seal) "' ` DANIELLE GONCMES �`', �= " .g� t�iY COMUiISSIOA! it GG 232946 L r � � ci PiRES: J�,re 27, 2D22 c � ' > � . u". d Tt ru P:ctwry Pi U+.c�envriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED kcv 1V/ 1L/ L1 "Treasure Coast 772-466-1095, 4252 Bandy Blvd- Fort Pierce, FL, 34981, Fax 772-318-6672* "Palm Beach 561-752-0214, 2758 Old Okeechobee, Blvd, SUIte 9, West Palm Beach, FL. 33409t-, Proposal / Agreement Linda Dombkowsk! January 27, 2022 6755 Sinsonte Ct Fort Pierce, Florida 34951 (239) 565-0224 1) Energized Electric will obtain permits to remove 25KW liquid cooled generator. 2) Disconnect electric to generator and remove generator and slab and dispose. 3) Disconnect electric to transfer switch and remove and dispose, install 12"x12;x4' Pvc 3 box in its place. 4) Test electric service & meet inspector for final inspection. 5) Replace 30 square feet of grass. r the sum of.- $1,145. 0�� Charges & Payments: Charges are due in full at time sTERMare rendered unless otherwise stated below. Contractor may charge and customer agrees to pay a late fee for all past due payments, such fees not to exceed the maximum allowed rate by applicable law. Customer shall be responsible and agrees to pay for all charges billed, applicable taxes, applicable legal fees and other charges/fees. Customer shall be responsible for any stop payment, charge backs or returned checks in the amount of $25.00 or 3% whichever is greater. Proposal/Contract pricing good for 30 days from Proposal/Contract date $ 295.00 is due @ Signing $ 900.00 is due @ Completion We appreciate the opportunity you have extended us to quote on this work and would like to thank you in advance for your consideration. Authorized signature Mike Raman ACC--- e�r�Ce Of PrQD[���I I, �-.- t "t'>A.. a o 10 1 (, authorize Energized complete the work in accordance with the above speeifi ations adnd ameconditions. I agree to pay asapero terms outlined above. Signature Date $395.00 of the initial deposit is NON REFUNDABLE if customer cancels after signing this contract or makes a deposit for any reason. No refunds will be given at all after permits have been applied for or installation begins This agreement shall be construed under the laws of the state of Florida. This agreement contains the entire understanding of the Parties and supersedes all previous verbal or written agreements: there are no other agreements, representations or warranties not set forth herein. If any conflicts exist in this agreement between terms which are printed and those which are typed or written, the typed or written language shall govern. Page 2 of 2