HomeMy WebLinkAboutgasAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/23/20 Permit Number:
94 ULCER
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR:GAS PIPING
1
PROPOSED IMPaROVfMENT L'OCATIOIV.
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Address: 3611 PROMENADE WAY
Property Tax ID #: 2433-502-0048-000-5
Site Plan Name:
Project Name:
INSTALL GAS PIPING FOR GENERATOR AND TIE INTO EXISTING LINE.
New Electrical Meter
Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 500.00
Name DENISE L. TORRE
Address: 63611 PROMENADE WAY
City: FT. PIERCE State:
Zip Code: 34982 Fax:
Phone No. 772-484-5008
Sq. Ft. of First Floor:
Lot No. —
Block No.
_ Windows/Doors Pond
Roof Pitch
Utilities: —Sewer _Septic Building Height:
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: CHRIS JOHNSON
Company: CNJ PLUMBING LLC.
Address:1701 S. 37TH ST.
City: FT. PIERCE State: FL
Zip Code: 34947 Fax:
Phone No 772-801-3073
E-Mail CHRISJOHNSON@FPUA.COM
State or County License 30950
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:_
Address:
MORTGAGE COMPANY: Not Applicable
Name:_
Address:
City: State: City:
Zip: Phone I Zip:
Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable I BONDING COMPANY:
Name:
Address:
City:
Zip:
Phone:
Name:
Address:
City:
Zip: Phone:
State:
Not Applicable
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or. an attornev before commencing work or recording your Notice of Commenceri=t.
Signature of Owner/ Lessee/Contrac as Agent for caner
Signatu a of Contractor/License Howe"'-
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF ,C , /Ac -/F
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Ph sical Presence or Online Notarization
r Physical Presence or Online Notarization
this day of t/ elf', , 2020 by
this ,t3 day of2020 by
Name of person making statement.
Name of person making statement.
Personally Known V OR Produced Identification
Personally Known Y OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
VV
(Signature of Nota rirla I
(Signature of Notary Public- State o Florida )
Commission No. ;� `�'• Notary Public�$��da
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