HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICA13L�EE,,INFO
((�MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED nn
Date: ' �T-1 Permit Number:
SCANNED
Building Permit Application �+ 1 By
Planning and Development Services St. LudeCounty
Building and Code Regulation Division
2300 Virginia Avenue, -Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial- - - -Residential_ X
PERMIT TYPE: Generator
PROPOSED IMPROVEMENT LOCATION.
Address: 12318 NW HARBOUR RIDGE BLVD, PALM CITY, FL, 34990
Property Tax ID #: 4426-600-0005-000-7 Lot No.4
Site Plan Name: Block No.
Project Name: Coy
Supply and install 22kw generator with 200 amp service entrance rated transfer switch and load sharing modules
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 11095.00 Utilities: -Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE: '
CONTRACTOR.
NameAdelaide Coy
Name: Michael Flaxman�
Address:2740 SW Martin Downs BLVD # 231
Company: Energized Electric
City: Palm City State: _
Zip Code: 34990 Fax:
Phone No.
Address:4252 Bandy Blvd
City: Ft Pierce State: FL
Zip Code: 34981 Fax: 7723186672
Phone N07724661095
E-Mail:
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.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION CIEN'LAV1/ INFORMATfON;
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY. _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Zip
_ Not Applicable I BONDING COMPANY: _Not Applicable
Address:
City:
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 NOTIC OF COMMENCEMENT."
Signature of O r/ Lesse /Contractor as Agent for Owner
Signature of on actor/License der
STATE OF FLORIDA
STATE OF FLC IDA
COUNTYOF Si•- (,ycig,
COUNTYOF 15t. Lueie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this_/_dayof'Svly .20-ft by
this1,Ldayof Tully .tog by
Michael FIC'Xiyian
1AIr-V% I Fnxweig)
Name of person making statement.
Name of person making statement.
Personally Known )4. OR Produced Identification
Personally Known T—OR Produced Identification
Type of Identification
Type of Identification
Produced
�•%t.t.(,�lal.(2 I„r �i.Nd
Produced
a �.ka-�a a,w*1
(Signature of Notary Public-S to of Florida)
(Signature of Notary Public -'State of Florida )
Commission N ... ''• NICIIOLE RaqNTE
Commissio NICHOLE APQ�
- ='E MyCOMMISSION # FF963031
•': MY COMMISSION # FF983031
2 20
REVIEWS
ERVISOR
PLANS
NGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19