HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (y / f Lr qo7
Date: 10/2112019 �j Permit Number: t I r-n
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia A. venue, Fort Pierce FL 34982
Phone: (772)1162,-1553 Fax: �772) 462-1578
Building Permit Application "eQd
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Commercial Residential X
PERMIT TYPt:GAS TANK AND LINES
PROPOSED IMPROVEMENT LOCATION:
Address: 5012WATERSONG WAY
Property Tax ID 11: 2532-500-0081-000-6 Lot No.
Site Plan Name: Block No.
Project Name: TAYLOR
I DETAILED DESCRIPTION OF WORK: 1.- I
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical -Gas Tank _ Gas Piping _ Shutters
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ -::I q 15. A CZ
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Greg Taylor Christine Taylor
Name: PAUL DRAGHI
Address:4001 N Ocean BLVD, Unit Apt 1102
Company, PAULIE PROPANE 8 NATURAL GAS SYSTEMS
Address:4100 SE SALERNO ROAD
City: Boca Raton, FL State: _
Zip Code: 33431 Fax:
Phone No.
City: STUART State: FL
Zip Code: 34997 Fax:
Phone No 7721220-2616
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail pauliepropane@gmail.com
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC Is $7500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 O JOB SITE BEWRE THE FIRST INSPECTION. IF YOU WrEND TO OBTAIN FINANCING, CONSULT
WITH YOUIR LENIXER OR AN RNEY BEFORE RECORDING YOUR CE OF CO MENCEMENT."
Signature ofOWJ6Ar/ Lessee/Coc r as gent for Owner Signatur of 6ritralfdr/AzAe f older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF M A RI I N COUNTY OF UYl ( I
The forgoing inst m nt was acknowledged before me
this! day of �I Cj��b4✓C_ 20i q by
I N1J �. e-RG µ; rT
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of Identification
Commission No.,'�-ypg(
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REVIEWS FN P,
COUNTER 2
DATE REMIN
RECEIVED
DATE
The forgoing ins rum n was acknowledged before me
this _?-,O day of0— 20f 04by
Name of person making statement.
Personally Known " OR Produced Identification
Type of Identification
(Signature of Notary
Commission No.
JPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW
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