HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -
Date: ? I '-2x. Permit Num
Building Permit
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce A 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
UIRA
:ation FEB 3 2020
Permitting Department
St. Lucie County, FL
PERMITTYPE: LP GAS -RESIDENTIAL
PAOPOSEb,IMPROVEMtNt,,LOCATION.,:�'.',Y'',,--,.-;
Address:J i uj t- ieetwoOCI Ln
Property Tax lD #: 3404-806-0010-000-6 Lot No. 10
Site Plan Name: Emigholz Block No.
Project Name: Emigholz
Run 15' of underground LP Line from the existing uderciround LP tank to the aenerator.
CONSTRILIC'17.10WINFORMA I Tr10N,
Additional work to be performed under this permit- check all that apply:
—Mechanical _Gas Tank X Gas Piping Shutters Windows/Doors
— Electric —Plumbing — Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1061.55 — Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:.
RAUPR:
CONTRACTOR:;',
Name Christopher Emigholz
Name: Tom Fite
Address: 1103 Fleetwood Ln
Company: Ferrellgas
Address: 3232 SE Dixie Hwy
city. Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 770-696-8951
E-mail: ch ristopablo0cl mail. com
city: Stuart —state: FL
Zip Code: 34997 Fax: 772-287-3456
Phone No 772-287-4330
E-Mail KimWilkins@ferreligas.com
Fill In fee simple Title Holder an next page( If different
from the Owner listed above)
1
state or county License 31370
--- —
f value of construction Is 52500 or more, a RECORDED Notice of Commencement Is required,
If value of NVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
It
DESIGNERIENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not.Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
_
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 ermit holder to build the subject structure
Home
which is in conflict with any applicable Owners Association rules, bylaws rannScovenants 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 SRE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIT OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
Signature of Owner/ Lessee Contractor as Agent for Owner
Signature of Contractor/License Hol er
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _ day of 20_ by
this_ day of 20_ by
Tom Fite
Tom Fite
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification _
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produ d
Produceo
)dLv Z. UA-y
(Signature of Not Publi c on i BERLEYL. WILKINS
( nature of Note P Iic-
'�'• p�Y COMMISSION#FF 06310
Commission No. FF063 '' y S:Novorber28,202
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C missionNo. F 0631 _ �@,AERLEYL• WILKINS
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MISSION# FF 0631C
Ora 'o= EXPIRE S:Nover.,ber28, 202
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