HomeMy WebLinkAboutFuel.Gas_Holmes 13019 Harbour Ridge Blvd_App&ContractAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: LP GAS
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential X
Address: 131019 HARBOUR RIDGE BLVD PALM CITY FL 34990
Property Tax ID #: 4426-830-0004-000-7 Lot No.
Site Plan Name: HOLMES
Project Name:
DETAILED DESCRIPTION OF WORK:
Block No.
INSTALL 57 GAL LP HORIZONTAL TANK/LINE TO WATER HEATER & RANGE
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical VGasTank VGasPiping_Shutters
_ Electric _ Plumbing
Total Sq. Ft of Construction: 2039.53
Cost of Construction: $
_ Sprinklers
_ Generator
Sq. Ft. of First Floor:
_ Windows/Doors
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Tom Fite
Name: Tom Fite
Address: 3232 SE DIXIE HWY
Company: Ferrell as
city: STUART State: FL
Zip Code: 34997 Fax:772-287-3456
Phone No.772-287-4330
Address: 3232 SE Dixie Hwy
city: Stuart State: FL
Zip Code: 34997 Fax: 772-287-3456
Phone No 772-287-4330
E-Mail KimWilkins@ferrellgas.com
E-Mail: KimWilkins@ferreligas.com
Fill in fee simple Title Holder an next page ( if different
from the owner listed above)
State or County License _ 31370
IT value or construction is >cDuu or more, a KtLuKutu Notice or Commencement Is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State: _
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
•• �ry . r.. l W n nrrnvvr r : Nppucaoon is nereoy mace 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 1 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 Vnun runnrr nr rnmururrrrur e
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The forgoing instrument was acknowledged before me
The for oing instrument was acknowledged before me
this3j dayof AUGUST 202Q by
this 3 day of AUGUST 202Q by
Tom Fite
Tom Fite
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification _
Personally Known V OR Produced Identification
Type o Identification
Type of Identification
Produc d
Produced
(Signature of No[ary Pu i $�yte'i?3f,FloridiI°
ignature of Notary Publ - —
MYCOD:IMISSIONNFF06310
.>^�e4g;�., KIMBERLEY L. WILKINS
Commission No. FF063 '` S:Noversher28,2021
�$
mmission No. FF06 - :,- MY �.SSIONHFF 063105
':FoF dip"` Bonded Thru Notary Public Underxritrs
- ;' EX IRES: Nover�her28, 2021
''+9r
flc°"' Bonded Thou Notary Public Undererlt;:
REVIEW5
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
cev. cy 1 / io
'$,nn
Doug Kelp
Account Managa-
772216. 2656 cell 772 287-3456 fax
US OIIIBr
0lW k Ferrell as.
ID 233971629
Charles Holmes
13019 Harbour Ridge Slvd
I1ate: 21-Jul.20
Palm City FL 34990
tease 200# Cylinder
c a eh7a—M com
Phone 210 557 2975
To Install;
HIM
20W PMPens Cylinder $
AG Installation —�� � Amiay a
'NSMUYaan
Ext Line Ue to 40' of gas dPinO 20.0.00
Flm nneen w,(aool aaa—��-b"unaueo.00.miaomip.r ma® $ 14.50
(xool Yp b. DNleaapra.5., gaayp.1ert�6
'�---�._� rpulmn M1..mlybr•pAY
Final Connect and 2 outlets
Regulators
3ub Total
Tax
Permit
TOTAL
_-375.00
$
340.00
$
— 1.579.00
7.00%_ $
11063
S
350.00
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Customer Signature; r "LA _ _Deas
Ferreligas Signature;
y.Margbm» Date: W�
Contact Informawri :
Penny Randall
Kim Mikins 561 746 4534 Ext 25104
Jane Conner 772 287 4330 Ext 22578
772 287 4330 Ext 25101
3232 SE Dixie Highway, Stuart FL 34997