HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / F04 — O
Date: �' ' Permit Num e • v
CEIVEU
MAN
SCANN
BII ft� it Applicatio JUN 18 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie
2300 Virginia Avenue, Fort Pierce FL 34982 ty, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentla
PERMIT APPLICATION FOR: Generator El I
PROPOSED IMPROVEMENT LOCATION:
Address: 3006 Bent Pine Dr
Legal Description: Monte Carlo Country Club -Unit Three -Lot 265(OR 4020-434,437:4125-1827
Property Tax ID #: 1327-701-0085-000-8
Site Plan Name: James Wade
Lot No.265
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 22KW generator with 200amp automatic transfer switch with load sharing modules
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit — check a apply:
EIHVAC E] Gas Tank ❑Gas Piping Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator 1Roof Roof pitch
Total Sq.,Ft of Construction:
Cost of Construction: $ 3659.20
S Ft. of First Floor: _
Utilities:cnSewer Septic
Building Height:
OWNER/LESSEE: -
CONTRACTOR:
NameGRBK GHO Meadowood LLC
Name: Michael Flaxman
Address:590 NW Mercantile PI
Company: Energized Electric
City: Port Saint Lucie State:FL
Zip Code: 34986 Fax:
Phone No.954-562-1476
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
E-Mail: EnergizedGenerators@gmail.com
State or County License: EC13006279
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: GRBK GHO Meadowood LLC
MORTGAGE COMPANY: _ Not Applicable
N a m e : Micahel Flaxman
Ad d ress: 3006 Bent Pine DR
Address: 590 NW Mercantile PL
City: Port Saint Lucie State:
Zip: Phone
City: FortPierce State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: 4252 Bandy Blvd
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
commencing work or recording our Notice of Commencement.
Signature of 0 - er/ essee p ntractor as Agent for Owner
Signature of ntfactor/Li ense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF .
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of -Xv.,, L 201L by
this 1T_ day of Vyr-e_ 20jL by
IM t c kcL¢, I fi-ixy m
W C k a 'li A Q x ny"
Name of person making statement
Name of person making statement
Personally Known X OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Q"W�
(Signature of Notary
b ic- Statee of Florida
(Signature of Notary Public- State of Florida )
Commission No.
k91DSa
=a' =Commission
No.;�°%NiC6�6�tga1P®�dTE
LAPONTE
Y OOM lISSI9o"3031
EXPIRES M020
Y COMMISSION #FF963031
•'.'?ociio�``` EXPIRES May 04, 2020
(4C7) 393.0'S3
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17