HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I SCANNM Permit Number:
BY RECEIVED
Building Permit Application AUG 0 9 2010
Planning d Development Services Permitting DepartmentSt. Lucie County
Building a d Code Regulation Division
2300 Virgi is Avenue, Fort Pierce FL 34982
Phone: (7, 2) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT PPLICATION FOR: Generator
PROPOS tD IMPROVEMENT LOCATION:
Address: 9401 Avenel Ln
i Legal Desc
Property T
Site Plan N
Project Na
Setbacks
Pines at the Reserve Lot 13 ( OR 1133-1875; 3935 -756)
ID #. 3322-502-0019-000-5
. Bullis
'ont Back: Right Side: Left Side:
I, DETAILED DESCRIPTION OF WORK:
Lot No.13
Block No.
Install 22 '''
1
generator with 200 amp transfer switch with load sharing modules
CONSTRUCTION
INFORMATION:
lAdditional
nHVAC
or to e e orme under this permit— check a apply:
Tank ❑Gas Piping Shutters
Windows/Doors
Gas
_
F]
Generator
E] Roof Roof
Electri
Plumbing
Sprinklers
pitch
total Sq. Ft
Construction:
9900.00
Sq. Ft. of First Floor:
OSewer 0Septic
Cost of Cons
ruction: S.
Utilities:
Building Height:
OWN ER/LLSSEE:
CONTRACTOR:
NameRandy;Bullis
Address:940
City: Port Sa
iZip Code: 34
Phone N0.7
JE-Mail:
Fill in fee sim
from the Ow
Name: Michael Flaxman
Company: Energized Electric
Address: 4252 Bandy Blvd
Avenel Ln
t Lucie State: F�
86 Fax:
0-466-6795
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
le Title Holder on next page (if different
er listed above)
E-Mail: EnergizedGenerators@gmail.com
State or County License: EC13006279
If value of
is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLE �i ENTAL CONSTRUCTION LIEN LAW INFORMATION:
DE-SIGNE
/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Rand
IBullis
Name:MichaelRaxman
Q1 Avenel Ln
Address:
Address: 9401 Avenel Ln
Lucia State:
City: PortSai
City: Fort Pierce State:
Zip:
Phone
Zip: Phone:
FEE SIMPL, TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:4 '2Bandy Blvd Address:
City: City:
Zip: Phone: Zip: Phone:
I
OWNER/ C NTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
' I certify that o work or installation has commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co lict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Ple se consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideratilin of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance iuith the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory strut tures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING "O OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improveme its to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the I,rst inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work r recording our Notice of Commencement.
i
Signature of
by$nepf Lessee/Contractor as Agent for Owner
Signatur of ntractor/License Holder
STATE
LORIDA�'
OF ORIDA�� �
COUNTYF
�'
COUNTYOFSTATE
b iLi
e'
—acknowledged
The forgoing
nstrument was acknowledged before me
The forgoing instrument was before me
this da
of 204- by
this day of u 20� by
Hwk/i
Iaimnn pew„p
r `��S � hQ4
• ho''r
to
o
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Na
Personally K
a of pers n making statement
own OR Produced Identific
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Name of er on making statement �- °• ► r;
Personally Known OR Produced Identification in
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Type of Iden
�ification
on-eile-��"
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Type of Identificati n 3
Produced
< 3 0
co
Produced `0 3 °.
to3•-"(A
E3N�'D
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ca
Ny GSL
N
(Signat e o
Notary Public- State of Florida)
a; c
IgnaJurf Notary Public- State of Florida) N X N
Commission
o. (Seal)
N
v, 2
Commission No. (Seal) ,o cc r-
® o" m
w.4
W I! Q
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
iDATE
RECEIVED
DATE
COMPLETE
Rev. 8/2/17
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