HomeMy WebLinkAboutSPARKS GAS PERMIT APPICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
– Permit Number:
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
11 "PERMIT TYPE: —C— —I ,�7 ��
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Address: �gro
Property Tax ID #: RSZe-7--M
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Site Plan Name:
Project Name:
CONSTRUCTION UC1 CpN INFQRMATION.
Building Permit Application
Commercial Residential y
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Additional work to be performed under this permit– check all that apply:
—Mechanical Gas Tank
XGas Piping — Shutters
— Electric — Plumbing — Sprinklers
—Generator
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ '!�, s'p� 19
Utilities: _Sewer — Septic
Address: Name:
Company
City:. Vii- � � p y:
�i' State: Address: s�
j Zip Code: 154 O 't Fax:- `
f Phone No. 77.7" _City:
E -Mail D Zip Code:
Serve c ,
Fill in fee simple Title Holder on next page (if diffe different Phone N
from the Owner listed above) Mail
State or County License
F value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Lot No.
Block No. t'
_ Windows/Doors
Roof Pitch
Building Height:
State: -L4-
_Fax:
Name:
city:
Zip:
FEE SIMPLE TITL H LOE H LOE DE
Name:
Address:_
city:_
Zip: Phone:
Not App
Not Applicable
OR !1r ATI
MORTGAGE COMPANY:
Name:
Address: '
City:
Zip:Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
_Not Applicable
UWINI"R/ CONTRACTOR AFFIDVIT: Application is hereby made t btain 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 Assouation rules, bylaws or and covenants that m
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
may restrict or prohibit such
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
"WA MINC TO OWNER: YOUR FAILURE TO RECORD A use
TWICE FOR ENCEM
YOUR
TO YOUR PROPERTYNA NOTICE F COMMENCEMENT MAT MU L IN
AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU BE
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
INTEND TO OBTAIN FINANCING, CONSULT
Signatu f Owner/ Lessee/Contractor as Agent for Owner
IOLINTYOF TATE OF FLORID
The f9ping instrumevt w46 acknowledged before me
this -L& day of 20AD by
1 _
Name of person aking statement.
P sono)) Known "� OR Produced Identification
ype of ntification
Produc ! f`
of
/License Holder
STATE OF FLOR D
COUNTY OF
The forgo . ng instrum t was acknowlecla efore me
this day of 2tby
I
Name of person making tatement.
Personally Known ✓ OR Produced Identification /
Type of tification
Produ ed It
Com ssion No, oAW °ys� Nctary ?ubl c Slate of Florida
harmin j,Seml er
NrMy+.,omm ss r,n 22582; Cor miss
REVIEWS ,�-•..�.ro.....- '
FRONT ZONING SUPERVISOR PLANS
DATE COUNTER REVIEW REVIEW , REVIEW
RECEIVED
DATE
COMPLETED
re of Notary Public -
Notary Public6 Rte of Florida
rmin D 1 .
i My Commission GG 22527
_Expires 06/06/2022
VEGET+'flP'R SEA TURTLE ]-,�;N-
GROVE
REVIEW REVIEW REVIEW