HomeMy WebLinkAboutPERMIT APP 6-8-20All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/8/20
•
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 1508 NW SAWGRASS WAY
Property Tax ID #: 4426-815-0066-000-2
Site Plan Name: HOSHINO
Project Name: HOSHINO
Permit Number:
Building Permit Application
Commercial Residential X
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: —
EXTERIOR LP GAS TANK AND LINES
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
_Mechanical Gas Tank CK Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 2300
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NamePatricia L Hoshino (LF EST)
Name: Cheyenne Ellison
Address:1508 NW Sawgrass WAY
Company: Elite Gas Contractors
City: Palm City, State: _
Zip Code:34990 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 18361
-- ---- - -- --•- •-•• •- I---- - . w. _ . && WRUC., rvuuce ar Lammencement 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
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 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."
Ki
Sige of ner/ Les ee/Contractor as Agent for Owner
Signature of Cont for/License Holder
STATE OF FLORIDA
COUNTY OF Maws-i v,
STATE OF FLORIDA
COUNTY OF M c.y -" v..
The forgoing instrum nt was acknowledged before me
this_'[dayof��UNe 20�6y
The forgoing instrum nt was acknowledged before me
this day of r,�uY�e_,20�1('jby
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Name o erson m7OR
Name of per n making atement.
Personally Known Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
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P duced
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Commission No. Desiree NAP&Intosh
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
S R L
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.