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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 1-0-ON-7-
RECEIVED
Building Permit Application , SEP.10 2017
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Generator
PR!®P®SE® L.MtPR®�/E(�/IENI" LOCATI®N�: s
Address: 5409 Eagle Drive Fort Pierce FL 34951
Legal Description: Holiday pines s/d phase II B Lot 272
Property Tax ID #: 1312 801 0076 000 3
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.273
Block No.
Install 22kw standby generator with 200amp service entrance R.."A
jditional worK to be ertormed un
11HVAC Gas Tank
11 Electric 0 Plumbing
:)ermii — cnecK aii apply:
Gas Piping _ Shutters
Sprinklers Generator
Total Sq. Ft of Construction: S�Ftj of First Floor: —
Cost of Construction: $ AID0, Utilities: nSewer []Septic
Windows/Doors
Roof Roof pitch
Building Height:
0WXSR/LESS'EEt
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I
,AC
NameMNA 10UMName:
Company: la'NexnAnPA
Address:
City:
State:
Address: HT91 livA&I Nk)A
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Zip Code: 'A, Fax:
City: -
State: 'APhone
-Li
No. 1 2
Zip Code: Fax:
\ 0
E-Mail:
Phone No.
Fill in fee simple Title Holder on next page (if different
E-Mail: P mmccems,
cu
State or County License:
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Ap
Name:
Address:5409 Eagle Drive Fort Pierce FL 34951
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 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 our Notice of Commencement.
Signature o 0 ner/ Lessee/Contractor as Agent for Owner Signature o on(ractor/License Holder
STATE OF FLORIDA,-+ STATE OF FLORID
COUNTY OF ��a Q, COUNTY OF ,,�L�j�
The oing instr. e t was cknowledged before me
this day of 20 n by
Name of pers n making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature
Notary Public State of Florida
M Paula (Seal)
My Commission FF 191201
Expires 0212712019
The for oing instr ent was cknowledged before me
this ILI day of � 20a by
IV 1 vvx)�
Name of perso making statement
Personally Known OR Produced Identification
Type of Identification
Producedfi
0
(Signature of Notary Pu
Commission No. 4 e�AN Notary��++blic tateofFlorida
Antoni�'i5f�ula
1 :_ My Commission FF 191201
.r f:,, s o� Expires 02/2712019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNn TER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
Rev. 8/2/17