HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Kay
Building Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2366 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial --- Residential
Residential
PERMIT APPLICATION FOR:,a. rL
PROPOSED IMPROVEMENT LOCATION:
Address: 121 N. Jenkins Rd.
Legal Description:
Property Tax ID #: 2312-144-0001-000.4 Lot No.
Site Plan Name: Block No.
f
�.•rlf Project Name: &
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of compressed natural as re -fueling station. Including equipment, storage tank utility
building and concrete slab Ck� Cry y,a.aL�
. reke � `�T � e2!QiD CCTY_c°_5 r
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CONSTRUCTION INFORMATION:
Aaartional work to e ertormed un ert ispermit—check all apply:
E1HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric 0 Plumbing Sprinklers []Generator ❑_ Roof
Total Sq. Ft of Constructio r S Ft. of First Floor:
Cost of Constructio : $ o d Utilities..Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Consolidated Properties of FP
Name: Chris Parker
Address: 5561 N. University Dr. #103
Company: IGT Homes, Inc.
City: Coral Springs State: FL
Address: 8870 N. Himes Avenue
Zip Code: 33067 Fax:
City: Tampa State: FL
Phone No. 9 � y cS 22,11
Zip Code: 33614 Fax:
E-Mail: tAS (�P
Whone No. 813.992-5206
Fill in fee simple Title Holder on next page (if different
E-Mail: r4oa e -17,e- I- Z-;-y .
from the Owner listed above)
State or County License: CGC1519644
I value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I'SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
W&ONUr.Cni cnlaumcprc: _ Not Applicanle MORTGAGE COMPANY: Not Applicable
Name: Buchanan P.E. Conaulting,Inc
Name:
Address: 6191 W. Atlantic Blvd. q2
Address:
City: Margate State: FL City: State:
Zip: 33063 Phone: 954-590.3300
Zip: Phone:
FEE SIMPLE
Name:
Address: _
City:
Zip:
HOLDER: _ Not Applicable
e:
BONDING COMPANY:
Name: _
Address:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
_Not Applicable
St.
is In Count with any applicable )Hothat
e Owners Association) rulesabylaws or and Covenants that build O 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
rnmm..ring. u,n.L ............1:......_.._ er_.:__ _r ,-_
_ Signature of
STATE OF FLORIDA COUNTY OF
The for oing Instruct was acknowledged before me
thl RdayofAl U 20//,—,by
STATE OF FLORIDA, / J
COUNTY OF H.i�S/J✓��i
The forgoing instrument was acknowledged before me
this ,(o— day of , ')%Ai\(20 116 by
H td-110+'e l A s 1 kk.) ys Po vke.A )
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- State of Flo da) (Signature of Notary Public- State of Florida )
Personally Known / R ro u d dentificatlon Personally Known X OR Produced Identification
Type of Identification rogge Type of Identification Produced
A. `�• Notary. _PubI c •State of Florida FP' � (Seal)
Commission No.
•' ' •E Cpn(�n it FF 921372 Commission No.
My Colhrn. Ex Will Oct 9, 2019
Revised 07/15/2014 — v( KAREN Y NICHOL3-
.: 's uy nnUMISSION N FF9M
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