HomeMy WebLinkAboutBuilding Permit Application-DanielAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/10/2020
Permit Number:
2v. LLOMEI" �.
COUN
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Install 1000 Gal. U/G LP Tank & gas piping
PROPOSE[? IMP,ROVEMEN"f LOCATION:
Address: 2990 Johnston Road
Property Tax ID #: 1327-806-0004-000-9
Site Plan Name: Daniel, Duverton & Velania
Project Name: Daniel Residence-Peaco Builders
Install 1000 gallon underground LP tank with interior and exterior/underground gas piping
for Primary Building permit 2002-0499
New Electrical Meter Second Electrical Meter.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical
_ Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 6,000.00
_Gas Piping
Sprinklers
Lot No.4
Block No.
_ Shutters _ Windows/Doors _ Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Daniel, Duverton & Velania
Name: Brian M. Critoph
Address:2267 NW Padova Street
Company: C&C Diversified Services
City: Port St Lucie, FL State: _
Zip Code: 34986 Fax:
Phone No.772-216-9587
Address: 7954 SW Jack James Drive
City: Stuart State: FL
Zip Code: 34997 Fax: 772-266-4679
Phone No 772-266-4680
E-Mail:Jpease@peacobuilders.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail susan@ccdiversifiedgas.com
State or County License L121079
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
ell
Signature of Owner/ essee/Contractor as Agent for Owner
Signature of Contra or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Florida
COUNTY OF Florida
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
X Physical Presence or Online Notarization
this 31 day of August 2020 by
this 31 day of August 2020 by
Brian M. Critoph
Brian M. Critoph
Name of person making statement,
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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