HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE C11if OLETED FOR APPLICATION TO BE ACCEP" (1 _
Date: 05-13-2019 \ ,' fG 1 st?{ Permit Number: l 1 otS" n as
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:GENERATOR
PROPOSED IMPROVEMENT LOCATION:
�o SC BNyNED
St. Lucie COu* RECEIVED
Building Permit ApplicatiEnM
AY 14 2019cie County, Permitting
Commercial Residential X
Address: 11900 Twin Creeks Drive, Fort Pierce, FL 34945
Property Tax ID #: 2333-601-0004-000-2
Site Plan Name: 11900 TWIN CREEKS DR
Project Name: Rodney Black - Generator
DETAILED DESCRIPTION OF WORK:
INSTALL A 22 KW GENERATOR WITH AN AUTOMATIC TRANSFER SWITCH
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical
\%Electric
_ Gas Tank
Total Sq. Ft of Construction:
Plumbing
Cost of Construction: $ ? . rpbo
Gas Piping
_ Sprinklers
_ Shutters
✓enerator
Sq. R. of First Floor: _
Utilities: _Sewer _Septic
Lot No. LOT 4
Block No. -
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:_
Name RODNEY BLACK
Name: MATTHEW RAULERSON
Address: 11900 TWIN CREEKS DRIVE
Company- MATTHEW RAULERSON INC
City: FORT PIERCE State: _
Zip Code: 34982 Fax:772-210-5928
Phone No'772-210-6100
Address:709 KEARNEY ROAD
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-210-5928
Phone No772-210-6100
E-Mail:MRAULERSON@THEE:XPERTS.BIZ
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail MRAULERSON@THEEXPERTS.BIZ
State or County License EC13008220
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is 'required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTR ION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF C-OMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature o ontractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OFMA+TIN
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this _ day of 20_ by
this day of MAY 20_0 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identificati n
Produced
Produced
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(Signature of Notary Public -State of Florida)
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