HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:'s , is, oe ' SCANNED Permit Number: 141 1 - C3 5a4
Sy RECEIVED
St. CuCle County
Building Permit Application NOV 2 S 2018
Planning and Development Services ST. Lucie ceuntyf Permltting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial YES Residential
PERMIT APPLICATION FOR: Generator I II
PROPOSED IMPROVEMENT LOCATION`.
Address: 7300 Oleander Avenue, Port Saint Lucie,FL
Leeal Descrintion: MODEL LAND CO'S S/D OF SEC 15 3640 BLK 3 S 112 OF LOT 3-LESS E 50 FT... Port Saint Lucie
Rehabilitation Nursing Home
Property Tax ID #: 3415-501-0042-000-7 Lot No.3
Site Plan Name: Block No. 3
Project Name: PSL Nursing GENERATOR AND ATS
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Wire for and install customer supplied 350kW Generator and 1600A 120/208V SER ATS - per
engineered plans
CONSTRUCTION INFORMATION: -
AdUitional worK to De_p_e� orme under tis permit— cneCK all apply:
LIHVA( Gas Tank Gas Piping In Shutters❑Windows/Doors
Electric Plumbing Sprinklers 9 Generator O Roof = Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 207,000
1
S Ft, of First Floor: _
Utilities: Sewer E]Septic
Building Height:
OWN ER/LESSEE
-ONTRACTOR:
lIfiame Eden Park Management, Inc % Millenium Management LLC
Name: Thomas M Henry
Address:10800 Biscayne Blvd, Suite 600
Company: Technical Electric Systems, Inc
City: Miami State: EL_
Zip Code: 33161 Fax:
Phone No.772-466-4100
Address:
City: DeBary State:FL
Zip Code: 32713 Fax: 386-668-8908
Phone No. 386-668-0691
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: office@tesfia.com cc:mweiler@tesffa.com
State or County License: EC0002683
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required. a,tE 1 13
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name • Thompson and Youngmss
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: B..Rawn State: FL
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
coDirnencinR workednecordinR Your Notice of Commencement.
e of Owne essee/Contractor as Agent for Owner
Signature Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Mar�i/I
COUNTY OF \/OLUSIA
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged �7efore me
this 1�dayof /✓OVerAber 20L by
this 117 dayof PIAVt0!&dPV__ .201� by
Zev Shernesli
—T--fk KL"L&6a
Name of person making statement
Personally Known _y/ OR Produced Identification
Name of person making statement
Personally Known _ OR Produced Identification
Type of
Produelddentification
Produced IdentificationType of
.
.SAOL4 L Get �it1S
(Signature of No Public-Sta
(Signature of Notary Public -State of Flora �y
•••'jR�q
Commission No. FFQ7r753
., SHARON WILKISON
r°��° MMMISSION#FF970W
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17