HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/10/20
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 5088 TREE TOP TRL
Property Tax ID #:1418-214-0015-000-1
Site Plan Name: HAYES
Project Name: HAYES
Permit Number:
RFb
'�F9 �Fo
I j
P
Building Permit Applicatidi '�9 4?e
4p�POppd
Commercial Residential X
DETAILED DESCRIPTION OF WORK:
EXTERIOR ABOVE GROUND LP TANK AND INTERIOR LINES
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Lot No.
Block No.
_Mechanical _ Gas Tank _ Gas Piping _Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:.
Cost of Construction: $ 2000
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Caleb Jordan Holden, AnnaMarie Hayes
Name: Cheyenne Ellison
Address:201 Rosewood DR
Company:Elite Gas Contractors
City: Fort Pierce State: _
Zip Code:34947 Fax:(772)220-1829
Phone No. (772)220-9678
Address:2130 Poma Drive
City: Palm City State: FL
Zip Code: 34990 Fax: (772)220-1829
Phone No(772)220-9678
E-Mail:emcintosh@elitegasco.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail emcintosh@elitegasco.com
State or County Licenser
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 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 TITLE HOLDER: _ 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 COMMENCEMENT."
&o�le G=
/Zm Z����
SillWurV4 Owner/ Lessee/Contractor as Agent for Owner
Signafore of ?,tractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF Mar -Ilan
COUNTYOF Marl
-ill
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thhii�s 4a day of Fir eb�0mr3jQj 20by
this 1Q day of
20�by
C
Name oNkrson making statement.
Name o rson making tatement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(' nature f No ary Pub'
Notary Public Stets of Florida
ure o ary li o �ofri a
� Notary uolic Slate of Fbdde
Desiree N McIntosh
D r N McIntosh
Commission No. Mnission GG 283399
ornmisslon No
M; C(S;Swon GG 283399
pp� Expiresi2/t 1I2022
mA Expires 12/712022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19