HomeMy WebLinkAboutPERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/20/20
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
I'tKi\al I I YPE:GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 5149 WATER LILLY WAY
Property Tax ID #: 3404-809-0013-000-6
Site Plan Name: BACON
Project Name: BACON
Permit Number:
Building Permit Application
Commercial Residential X
Lot No.9
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 IX Gas Tank k 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:
Name Michelle Jabeth
Name: Cheyenne Ellison
Address:5149 Water Lilly Way
Company:Elite Gas Contractors
City: Fort Pierce State: _
Zip Code: 34981 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)
If —1— - f ......a....�:.-- :- _ Hmn
E-Mailemcintosh@elitegasco.com
State or County License 18361
-- ----- --- --•- •-•• •- ---- a ur commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
City: State: _
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
City:
Zip:.
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phon
�VvIVIcn/ wry I nest- I UM /lrriUVI 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,
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."
Signature of Iw / "Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTYOF Ma r:i w
The forgoing instrument was acknowledged before me
this �dayof instrument
20_'?�Dby
Name of.#erson making statement.
Personally Known OR Produced Identification
Type of Identification
(Signature
" Notary Public�,$tta�tGGppr Florida
Commission No.
free N Mcl 19h
y - My Commission GG 283399
Expires 12/11/2022
REVIEWS FRONT ZONING
I COUNTER I REVIEW I SREVIEWOR
Q/✓ ��
Signature of Contr or/License Holder
STATE OF FLORIDA
COUNTY OF N&x i r.
The forgoing instrument was acknowledged before me
this y_Q day of t �u1 y , 20.—�Vby
Name of 3Fson making stptement.
Personally Known �// OR Produced Identification
Type of Identification
of
Commission No. +00`0� NotaryPublic Mate paI Florida
siree N W9,9 h
.1 c. • My Commission GG 283399
ora� Expires 12/11/2022
PLANS � RE EW VEGETATION EV EWI S REVIEW LE I R E EWVE