HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� _
Date: In Permit Number: Y 111 V1A r 0 aq1
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Building Permit Application JUL ; 3 2017
Planning and Development Services
Building and Code Regulation Division PER AI?-` iF.C�
2300 Virginia Avenue, Fort Pierce FL 34982 Si. Lucie
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line �-
L4VPROPOSEP.®VEMEeN
Address: 1507 NW Lancewood Terrace Palm City FL 34990
Legal Description: Harbour Ridge- Plat 8- east hammock Village Unit 4
Property Tax ID #: 4426-803-0014-000-6
Site Plan Name:
Project Name:
Setbacks Front Back: -
Right Side: Left Side:
Disconnect Gas line from exsiting generator and reconnect to new generator
11HVAC
Electric
Plumbing
U Sprinklers
Generator
Lot No.
Block No.
QWindows/Doors
Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 295.00 Utilities: Sewer septic Building Height:
01NNER/lESS'EE
Name David Jatlow
Name: Robert Binkowski
Address:1507 NW Lance wood terrace
Company: Energized Gas
Address: 4252 Bandy Blvd
City: Palm City State: FL
Zip Code: 349990 Fax:
City: Fort Pierce State. FL
Phone No.
Zip Code: 34981 Fax: 7723186672
E-Mail:
Phone No. 7727778133
Fill in fee simple Title Holder on next page ( if different
E-Mail: Antonella@Energizedgenerators.com
State or County License: 34747
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN, LAW INFORMATION:=:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
Zip: Phone:
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 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
STATE OF FLORIDA
COUNTY OFS.In,I.d.
as Agent for Owner I Sign
The f oing instru ent w s ac owledge fore me
this day of 20 Yby
Robert Binkowski
(Na e f person acknowledging
(Signature of Notary Public -'State of Florida )
Personally Known x
Type of Identification
Commission No.
Revised 07/15/2014
OR Produced Identification
Notary (SMA)State of Florida
Antonia M Paula
F My Commission FF 191201
STATE OF FLORIDA
COUNTY OF ...... -
The forgoing instrument was acknowledged before me
this 3 day of "y , 20 by
Robert Binkowski
(Name of a son acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. �"`"`
Notarybil SSate of Florida
Antonil�l6ula
t�
My Commission FF 191201
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Expires 02/27/2019
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