HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR
Date:
Buiclld
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
.ICATION TO BE ACCEPTED f O (/�" 053 2—
Permit N r
ED
®rmit Applicati n MAY 18 2018
Permitting DepartrnE 1`4'
St. Lucie County;_J
mmercial Residential XXX
PERMIT APPLICATION FOR: Generator I
PROPOSED IMPROVEMENT LOCATION:
Address: / 711 N AJ burr2vo6t Sl41r— &m e ffy .5t:�_ `YqT &
Legal Description: HARBOUR RIDGE -PLAT 148 DEER MOPS VILLAGE LOT11 (OR 2758-2425)
Property Tax ID #: PC ID # 4426-835-0021-00-7
Site Plan Name:
Project Name: 'rJiCi�_-� ��c1,61rc�l"l /D"e-
Setbacks Front Back: Right Silde: Left Side: _
DETAILED DESCRIPTION OF WORK:
Install 20KW/200amp Automatic transfer switch, (Generator & Slabj e-°"
Lot No.
Block No.
CONSTRUCTION INFORMATION:
1
AdditionaiworKtobenertormedunder this permit— checK
F]HVAC Gas Tank Gas Piping
all JbBJ apply:
Li Shutters
Windows/Doors
11 Electric ❑ Plumbing
L� Sprinklers
9 Gerierator
0 Roof Roof pitch
Total Sq. Ft of Construction:
SFt of First Floor:
Cost of Construction: $ 8,900.00
Utilities: Sewer E]Septic
Building Height:
OWNERAE7SSEE: j
CONTRACTOR:
Name lac, 'Nc Cam. /C-h V 2)aT;
t�
Name: �ob---i- S;ur2
Company: Sam Crane Electrical,LLC
Address: % 71 q IV&I ' u CUR .
City: �jjyl� Stater
Zip Code: ��C199 d Fax:
Phone No.
Address: 54SB SE 0'if��a2wAy
City: State: Xt
Zip Code: 3 i 7 Fax:
Phone No. (772)223-8865
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:. Samcraneelectrical@yahoo.com
State or County License: EC0001986
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
I
City:
Zip: Phone
State: I
I
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
I
I
Address:
City:
Zip: Phone:
Zip: Phone:
I
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 o 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 �o 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 obtai InI financing, consult with lender or an attorney before
rnmmencing wnrk nr recordine vour Notice of Commencement.
Signature of Owner/ Lessee/ ontr t or O
Signature of Contractor tcense Holdgf
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF--
COUNTY OF -
The forgoing instrument was acknowledg7refore me
day 20_ by
The forgoing instrument was acknowledged before me
this da of 20JY by
this/1 of
Cry,
e
Name of per n making statement
Name of pers making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification ll Ci
Type of Identification
Produced g;Zo BUG a
Produced
(Sig Hof Flor ` a)
MY COMMISSION�#FF 203187
(Sign
USA M. LEBRECHT
MY COMMISSION # FF 203187eal�+,
Com t N[;. FxPIRES: Ma4, 2019 eal)
Commio:
2019Bonded
e
Thru Notary Pc Undenmd t�
.'� j 1hd Banded Thru Notary Public Uryderwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17