HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \ QAaa � 1°\
Planning and Development Services
Building and CodeRegulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
Penult Number: ,*� 1 a 5 �i 13
RECEIVED
Building Permit Application DEC 2 0 2019
ST. Lucie County, Permitting
Commercial Residential
PERMITTYPE: LP Gas Tank and LP Gas Line
PROPOSED iMPROVEMENTLOCATION:.3755.Eleven Mile.Rcl, Fort Pierce, FL 34945
Address: 3t55 Lleven Mile Rd, Fort Pierce, FL 34945
Property Tax ID #: 2328-343-0000-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Treasure Coast GC/Lloyd
CONSTRUCTION INFORMATION
Additional work to be performed under this permit —check all that apply:
_Mechanical x Gas Tank X Gas Piping _Shutters -Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5742.80
Sq. Ft. of First Floor:
Utilities: _Sewer x Septic Building Height:
,OWNER LESSEE' °-
CONTRACTOR:
Name David & Linda Lloyd
Name: Tom Fite
Address: 3803 Eleven Mile Rd
City: Fort Pierce state: FL
Zip Code: 34987 Fax:
Phone No. 772-201-5423
Company: Ferrell-gas
Address: 3232 SE Dixie Hwy
City: Stuart State: FL
Zip code: 34997 Fax: 772-287-3456
Phone No 772-287-4330
E-Mail: treasurecoastgc(a)gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mall KimWilkins0ferrellgas.com
state or County License 31370
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.
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:
UWNtK/ LUN I KALI UK A"IUVI I: 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,
accessary 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
WFFKXO—Uk LENDER OR AN &TFOPAIEY BEFORE RECORDING YOU OTICE OF COM C "
L'�5<t , VL�
Signature of Owner/ Lessee Contractor as Agent for Owner
Signature of Contractor/License Holder
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
Produlled
L � 0A � A,
Produced
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�ure
(Signature & Nota ublic-Star
of Notary P i
"+` KIMBERLEYL.WILKI
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s7a KIMBERLEYL.WILKINS
MY( ISSION#FF 063[05
Commission No. FF063t0
fission No. FFO63
EXPIRES: November 28,
021
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Pei` EXPIRES; November28,2021
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