HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: A 2 '. N • 113 Permit Number:
Building Permit Appli
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553. Fax: (772) 462-1578 Commercial
PERMITTYPE:GaS
Address:
Property Tax ID q:
Site Plan Name: I
Project Name:—(
Additional work to be performed under this permit -check all that apply:
_Mechanical �asTank _GasPjping _Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 3 AS
ion DEC 17 W9
ST. Lucie County, Perry
Residential
Lot No.
Block No.
Windows/Doors
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/,LESSEE':
- - _ - - - -
CONTRACTOR.'
Name75 6tU 5 g 0 C.6
Name: Blake Cowdell
Address:r-
Company: Energized Gas
-
City: ?'I.. �' State:.X
Zip Code: 3Y k Cf Fax:
Phone No. ?T 2- T $" �l 't3�l ��
Address:1786 Biltmore Street
City: Port Saint Lucie State: FL
Zip Code: 34984 Fax: 7723186672
Phone N0772-466-1095
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail energizedgenerators@gmail.com
State or County License LG34747
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requireo.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
NEER: _ Not
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
93
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 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."
Signer/ Lessee/Contractor as Agent for Owner
STATE OF FLCII
COUNTY OFF C.CA
The f going inst ument was acknowledged before me
this(Edayof ' ° 20L9 by
Name of person making statement.
Personally Known ><- OR Produced Identification
Type of Identification
Produced
REVIEWS
RECEIVED
COMPLETED
9.P L CWax I
Signature of Contractor/License Holder
STATE OF FLORIna
COUNTY OF , ) 1 a
The forgoing instr ent was acknowledged before me
th�is, LL�?)-- day of �, 20� by
YY��c���l
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature
MY COMMISSION R
COUO TER NT I ROEVI NING W I SUPERVISREVIEWOR I REV EW I PNS VREVI WON I SEATURTREV EWLE I M EVIEWVE