HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST RF COMPI_FTFn FOR APPI ICATION TO RF ACCEPTED
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: GAS
PROPOSED IMPROVEMENT LOCATION:
AddreA Slash Pine TRL
Property Tax ID #: 1407-342-0025-000-4
Site Plan Name: DUNN
Project Name: DUNN
DETAILED DESCRIPTION OF WORK:
Permit Number: --
Building Permit Application t� 1
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Commercial Residential X
EXTERIOR LP GAS TANK AND LINES AND INTERIOR LP GAS LINES
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical I-
YGasTank Q[GasPiping _Shutters _Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:.
Cost of Construction: $ 4700
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameSteven R Dunn
Name: Cheyenne Ellison
Address.306 Lakeside LN
Company: Elite Gas Contractors
City: Addison State: \�T
Zip Code: 05491 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-Mailemcintosh@elitegasco.com
State or County License "3"
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:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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."
Sig re o wner essee/Contractor as Agent for Owner
Sig a of ntractor License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 4joy- im I
COUNTY OF MCi Y"44 ✓'1
The for oing instrument was acknowledged before me
day
The for oing instrument was acknowledged before me
iO
this of c I avl� 20Wby
this day of 2( by
r2ki o f p_Y J 6A
deA.e— S OyU
Name of son making statement.
Name of rson making statement.
Personally Known OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Rzoduced
Produced
Igna ure of otary Pu
(Slgnature of Wot7ary Public- F '
pr• Notary Public Stele of Florida
P&%
Commission No. Des)(�EeaNN McIntosh
3 My 6dKdi lesion GG 283399
hl ryPypIic State of Florida
Commission No. DIpl McIntosh
a n Expires 12111/2022
My Commission GG 283399
Expires 12M 2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/11