HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
1 SCANNED
Date: BY ! Permit Number: $�
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St Lucie County FA
IVED
Building Permit Applicatio6 2U18
Planning and Development Services nty, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 V
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residenti�l�.
PERMIT APPLICATION FOR: To Select from dropblox, click arrow at the end of line re
PROPO . ED�I IMPROVEMENT LO'CATI,ON:
Address:
Legal Description:
Property Tax ID #: 15;E!34'-Lot No.
Site Plan Name: --Firnc)+h" Block No.
Project Name:
Setbacks Front Back: Right Side: I Left Side:
DETAILED DESCRLFTION WO.RK'
�er�1c� �en�-r-o�c� ��ed �-�-rar►�r sL�r+c.-�
'' CONSTRU:CTION;J.N.FORIVIAThON�, � _ • .
Additional worK to be e orme , under this permit- check all that apply:
CIHVAC - Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
v Electric Q Plumbing Sprinklers Generator Roof Roof pitch
Total sq. Ft of Construction: S . Ft. of First Floor:
yfost of. Construction: $ �S utilities: _Sewer Septic
Building Height:
:WNER/LCSSEE:
;.CONTRACTOR:
- -
`
.:1ia;r'pe -
- i
Name: Micheal Flaxman
Addre
7
Company: Energized Electric "
City: 1
State: !
Address: 4252 Bandy Blvd,'
ity: Fort Pierce State: FL
Zip Code: Fax:" `- c��`7�— UJIU
Phone No. 12 "- �_ I C
Zip Code: 34981 Fax: 772-318-6672
No. 772-466-1095
E-Mail: I(i )
Fill in fee simple Title Holiler•on ne,
page { if differenP
,Phone
E-, ail: Jennifer.energized@gmail.com
from the Owner listed` above) , •' ;;,
•
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i.
State or County License:
If value of construction is 52500 or more, a RECORDED Notice of Commencement is requires.
I
;SUPPLEMENTAL C' NS RLICTL®NI LIENt LA�UI
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 4252 Bandy Blvd.
City:
Zip: Phone:
ORMATFQ
MORTGAGE COMPANY: Not Applicable
Name: Micheal Raman
Address:
City: Fort Pierce State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
)WINER/ CONTRACTOR AFFIDVIT: Application is herebv made to obtain a nermitto do the work and installation as indirated_
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 Owner's 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 your Notice of Commencement. _
Signature of 0 n / Les le/Contractor as Agent for Owner
STATE OF FLORIDI .
COUNTY OF '
The f 0/�trum nt was cknowled before me
th is Y eat zmn j 20 by
oho r,
L-t-j- rd
Name of peVbn making statement
Personally Known OR Produced Identification
Type of Ide
Produced
nn �
Sigrature of ContfactorXlcense Holder
STATE OF FLORI,[� '
COUNTY OF �-
The for i • s rume as cIF owledg ore me
thisA a 20 lc�by
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a c��
Name of p son making statement
Personally Known OR Produced Identification
Type of Identification, Y I f C �( ,,, � _ 1
Produced Y � `� ill L%(�C wr j
( ign ture of Notarg Public- State of Florida)
i
(Si ure of Notary Public- State of Florida )
Commission No. (Seal)
Com lion No. (Seal)
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Rev.
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