HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL A 'FULfAtSiLt INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
SCANNED
Permit Number:
011111111111 By
Le
• RECEIVED
�! Building Permit Application AUG 0 0
Plan i Ing and Development Services 18
Build1 g ana
Regulation Division
ST. Lucie Coun , Permitting
2300 �/irgiue, Fort Pierce FL 34982
Pho e: -1553 Fax: (772) 462-1578 Commercial Residential
PERMIT
APPLICATION FOR: Generator E
PROPOSED
IMPROVEMENT LOCATION:
Addres 1. 4245 S Indian River Dr
Legal 'ascription: 35 35 40 BEG AT PT ON W LI OF E 1/2 OF NE 1/4 1255.36 FT N OF S LI OF SE 1/4 OF NE 1/4
TH RUN N 00 FT, TH E TO RIV, TH SELY ALG RIV TO PT 1255.36 FT N OF S LI OF SE 1/4 OF NE 1/4, TH RUN W TO POB WITH RIP RT&LESS RD AND FEC RR- (14)
Prope I y Tax ID #: 4245 S Indian River Dr Lot No.
Site PI n Name: Block No.
Proiec Name:
Setba llks Front Back: Right Side: Left Side:
DET 'ICED DESCRIPTION OF WORK:
Install 22KW generator with 200 amp transfer switch with load sharing modules
CON;
Addit
IJ
Total
Cost a
RUCTION INFORMATION:
al work to be nerrormed under this permit— check all apply:
AC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
ctric 0 Plumbing Sprinklers R1 Generator D Roof Roof pitch
Ft of Construction:
)nstruction: $ 9995.00
S Ft. of First Floor: _
Utilities: Sewer []Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Addre
City: F'I
Zip Code:
Phone
E-Maillls
Fill in feFe
from tile
Rosalie Bloehm
Name: Michael Flaxman
s:4245 S Indian River Dr
Company: Energized Electric
Address: 4252 Bandy Blvd
rt Pierce State: FL
34982 Fax:
l 0.772-461-1656
City: Fort Pierce State. FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
simple Title Holder on next page ( if different
Owner listed above)
E-Mail: EnergizedGenerators@gmail.com
State or County License: EC13006279
If valuejof construction is $2500 or more, a RECORDED Notice of Commencement is required.
1
SUPPLEMENTAL
CONSTRUCTION LIEN LAW MFORMATION:
DESIGNER/ENGINEER:
N arr�e:
Ad d r
City:
Zip:
_ Not Applicable
Rosalie Bloehm
MORTGAGE COMPANY: _ Not Applicable
N am e: Michael Flaxman
Address: 4245 S Indian River Or
SS: 4245 S Indian River Or
Fort Pierce State:
Phone
I
City: Fort Pierce State:
Zip: Phone:
FEE
Name:
Add 1'6SS:
City:
Zip:
-I
IMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
4252 Bandy Blvd
Address:
City:
l Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certif that no work or installation has commenced prior to the issuance of a permit.
St. Luci County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which i in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structu e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons I eration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acco =dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fol owing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessc ry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impr511
ements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befo'the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comncinr; work or recording vour Notice of Commencement.
re of (vyher/ Lessee/Contractor as Agent for Owner I Signature,6f Contractor/License Holder
STAVE OF FLORIDA ` STATE OF FLORIDA �,
COUNTY OF SA-
_ I lLi ICOUNTYOF � �` I Iy—, IF
The forgoing instrument was acknowledged before me
this day of Au4`u S-V , 20A by �.
, I. I "I —i _ . �'
Name of per o making statement
Personally Known OR Produced Idi
Type Of Identification
Prod �ced
e of Notary Public- State of Florida )
on No. (Seal)
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this$dayof &9, S+ ,20M by
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Name of perso making statement
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Personally Known OR Produced Identificati
(Type of Identificatio
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