HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
p
Date: SCANNED) Permit Number: 1�03`03� 7
`a
at Lude COO _00
00 PEN,
Building Permit Application �,pRltiepaXk5r%e1%t
Planning and Development Services ; �e
PeTt�L�
Building and Code Regulation Division S •
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Generator E
'RORt�$D IMP101lEMENT Lt7*✓ATIt3N' ?'
Address: 14427 Dulce Real Fort Pierce, FL 34951 j
06 34 39 THAT PART OF SEC AS SHOWN IN OR 2380-1934 BEING LOT 14427 DULCE REAL (BLK 73 LOT 4)
Legal Description:
(0.13 AC - 5,720 SF) (OR 3744-2931)
Property Tax ID #: 1306-501-1077-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
y
Install 20kW Kohler generator and automatic transfer switch.
GG}N��t+Gfib�l INivIAION.z
iional work to be nerto,me i -nflpr this permit — c ec a apply:
Adilm
11HVAC Gas Tank ❑Gas Piping _ Shutters I] Windows/Doors
0 Electric 0 Plumbing Sprinklers R1 Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ $3,870.00 Utilities: Sewer Septic Building Height:
Q, E'LESEM
COITRACTtt R; -.
z:
10
,,.s,.... ..,..6F ..'.. ....... .:...., a «««...,..� ........, i
.......... ..... ............ ..%. .. ,., ..>.,.., .. tT,!,
Name Mary Ann Kloberg and Ellen Ortino
Name: Daniel S. Richmond
Address: 14427 Dulce Real
Company: WHITE ELECTRIC
Address: 645 3rd Place
City: Fort Pierce State:F�
Zip Code: 34951 Fax:
City: Vero Beach State:FL
Phone No.
Zip Code: 32962 Fax: 772-562-1410
E-Mail:
Phone No. 772-567-2642
Fill in fee simple Title Holder on next page (if different
E-Mail: info@whiteelectricvero.com
from the Owner listed above)
State or County License: EC13002005
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUP LC-IENTAL�CQI�iSRIJCTIQ LIEN�1t�1 IN
,
�tMAF[QN a`
�
�
DESIGNER/ENGINEER:
x Not Applicable
MORTGAGE COMPANY: _
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
city:
State:
Zip: Phone
IZip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
IBONDING 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 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
rnmmpnrino wnrk or rernrding your Notice of Commencement.
I
/
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA f�
V ?�l�
STATE OF FLORIDA� �` ��
COUNTY OF L'(mot
COUNTY OF 1 nQf j0A/) I U
yi r
The forgoing instrument was acknowledged before me
The for oing instrum nt was acknowledge before me
this � day of AA&P-& , 20)9 by
this day of 20) & by
—DAin-, a S. Pi & al D rd
�"e j S- 0 &I-nAid
Name of person making statement
Name of person making statement
Personally Known /,-'—OR Produced Identification
Personally Known / OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
/ &"-
p,,/
(SignatuW of Notary blic- Ste of Florida)
(Signature f6f Notary Pu��State of Florida )
F g
Fg562Z
/�"F gb'loZz�
Commission No.
Commission No.
•;w:eyB% MARY ELIZABETH ROTT
•:►:e••,, MARY ELIZABETH ROTT
=. Commission # FF 956228
.,,
_.. :.: Commission # FF 956228
o:
�� P,�,
`•• Bonded Th u Troy Fu
Insumee MUSS-7019
°�`•`
d n,T
F 1 � � . 9
REVIEWS
FRO
PLANS
VEGETATION
.
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17