HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�0
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �I �� Permit Number: 1,9'0q_ O(AR
RECEIVED
• _ SEP 2 8.2010
Building Permit Application Permitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Generator
=i,
PROPOSED IMPROVEMENT LOCATION:
S-CANNED
626 SE Hidden River Dr_ r
Bo
Address: �a o ,�_
�'b bHVttii o _ IL}1'
Legal Description: Hidden River Estates
Property Tax ID #: 3427-701-0028-000-4
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Install! 22KW generator with 200amp transfer switch with load sharing modules
Lot No.4
Block No. 2
CONSTRUCTION INFORMATION:
-A-dditional work to be nertormed under this permit— check all apply:
;_EIHVAC 0 Gas Tank Gas Piping fn Shutters Windows/Doors
0 Electric F]Plumbing ❑Sprinklers R1 Generator F� Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 9995.00 Utilities:0Sewer 0Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Thomas Maynard
Name: Michael Flaxman
Company: Energized Electric
Address:626 SE Hidden River Dr
City: Port St Lucie State: FI
Zip Code: 34983 Fax:
Phone 1No. 772-380-6911
E-Mail:
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
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:
NER/ENGINEER: _ Not Applicable
Narne: Thomas Maynard
Ad d ress: 626 BE Hidden River Dr
City- Pori sc L cie State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name: Michael Flaxman
Address: 626 BE Hidden River Dr
City: Fort Pierce State:
Zip: Phone:
FEEIiSIMPLE TITLE HOLDER: _ Not Applicable .BONDING COMPANY: Not Applicable
Name: Name:
Add ress: 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 certJfy 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 workor rpcordingyaur Notice of Commencement.
Signature of nell Lesseeltontractor as Agent for Owner
Signature of Co trac or/Li nse Holder
STATE OF FLORIDAc—. U
STATE OF FLORIDACO
IUNTY OF J 1► G _
COUNTY OF L CA �
The for oing instrument ent w s acknowledged before me
I3
The f r oing instru ent was acknowledged before me
day 20,by
this day of e- 20 by
this of
;was ► /y0
6�'
cho of El a�
1�
vd
Name of pe s n making statement
'°3 Om
ffff111111�
Name of personmaking statement
=°
Perri nally Known OR Produced Identifica
mnEn
Personally Known OR Produced Identification
Type of Identification
KID—
Type of Identification
Pr u d
� 3 - �
Produced
L_ o to
C3u,�'D
c
C�
�N QO7
fJ
3
y. yk m T
3
Siggatur of Notary Public- State of Florida) o -3 o
(Signature o Notary Public- State of Florida)
N N
NX u v)
ro0
o
f.�
Commission No. (Seal) �, rrn
Commission No. (Seal)
N X
N 0Go?G>
'O
CO)
REVIEWS
FRONT
ZONING'
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8%2/17