HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1,III "
ALL
Date:
Planning and Development Services
Buildini, and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
11
Phone (772) 462-1553 Fax: (772) 462-1578 Commercial
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: "
BY
at. Lucie (you*
Building Permit Application PeMitting D
St. Luce epan'ment
County
Residential
RECEIVED
JUL 10 2610
PERMIT APPLICATION FOR: Generator
PROPOSED IMPROVEMENT LOCATION:
Address: 8833 Lonesome Pine Trl
Legal Description: Hidden Pines Estates BLK C W 156.01 FT of Lot 16 (1.05 AC)(OR999-1940)
Propel y Tax ID #: 2323-701-0050-000-5 Lot No.
11
Site Plan Name:. - Block No.
Proje) t Name: Gahn
Setblicks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 22KW generator with 200 ampt transfer switch with load sharing modules
CONSTRUCTION INFORMATION:
itiona wor to je ne orme under this permit— check a apply:
L HVAC J Gas Tank ❑Gas Piping In Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers R1 Generator g Roof Roof pitch
Total al Sq. Ft of Construction: _
C?,st of Construction: $ 9795.00
S Ft. of First Floor: _
Utilities:(n Sewer 0 Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
ame William Gahn
Name: Michael Flaxman
�;'ddress:8833 Lonesome Pine Tri
Company: Energized Electric
City: Fort Pierce State: FL
Address: 4252 Bandy Blvd
II 34945
Zip Code: Fax:
,Rhone
Fort Pierce FL
City: State:
No.772-465-9373
Zip Code: 34981 Fax: 772-318-6672
E-Mail:
Phone No. 772-466-1095
Fill in fee simple Title Holder on next page ( if different
mail.com
EnergizedGenerators@gmaii.com
E-Mail: 9 @9
rom the Owner listed above)
State or County License: EC13006279
value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPL�,MENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable
MORTGAGE COMPANY: Not Applicable
—
11
N a me: T' iiam Gahn
Name' Michael Flaxman
Address 8833Lonesome Pine Td
Address: 8833 Lonesome Pine Td
City: Fortflierce State:
Zip: ill Phone
City: Fort Pierce State:
Zip: Phone:
FEE SIM' LE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Ad d res$I: 4252 Bandy Blvd
Address:
City: II
City:
Zip: Phone:
Zip: PI Phone:
�I
OWNER��CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify tf{' t no work or installation has commenced prior to the issuance of a permit.
St. Lucie CII unty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is i conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure lease consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consid " tion of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accord pce with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The follo 'lIing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessoryj$tructures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARM G TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improve' ents to your property. A Notice of Commencement must be recorded and posted on the jobsite
before �0e first inspection. If you in end to obtain financing, consult with lender or an attorney before
commebclne work or recording; voGr Notice of Commencement.
Signature of
as Agent for Owner I Signature
Holder
STAT 'OF FLORIDA I STATE OF FLORIDA
COUN4 ' OF S� Ly ore COUNTY OF GiJc I Q
The f r' oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 7u 1 11 .20, f L by this --li- day of l` u t y 20A by
Type
Prod
Rev
Name of pe son making statement
Ily Known OR Produced Identification
Identification
Michael Rctg Y1
Name of person making statement
Personally Known _ )C_ OR Produced identification
Type of Identification
Produced
of - (Signature -tate of Florida
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24i N ': : - MY COMMISS1010 fk963031 Commissio 6 MISSION 1t F 1
EXPIRES May 04, 2020 91v'Vol EXPIRES May 04, 2020
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