HomeMy WebLinkAboutStickradt - Permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S510 ULM
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: LP GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 5630 Sunberry Cir, Fort Pierce, FL 34951
Property Tax ID #: 1312-502-0209-000-7
Site Plan Name:
Project Name: Stickradt gas
DETAILED DESCRIPTION OF WORK:
Install 500g UG LP tank and line to generator and final connect
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
Lot No. 497
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical /Gas Tank ✓Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers ! Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ iso () Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jack Stickradt
Name: Manuel Tobar
Address: 5630 Sunberry Cir
Company:ThompsonGas LLC
City: Fort Pierce State:
Zip Code: 34951 Fax:
Phone No.
Address: 1786 SW Biltmore St
City: Port St Lucie State: FL
Zip Code: 34984 Fax: 772-206-3606
Phone No772-777-8133
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail mtobar@thompsongas.com
State or County License LQ32270
IT value or construction is t5uu or more, a KtWRLAIJ 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:
Address:
City:
BONDING COMPANY: Not Applicable
Name:
Address:
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.
2: L�A Z�
Signature of Owner/ Lessee/Contractor as Agent for Owner
�Z
Signature o Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFStLum
COUNTY OFSt Lucie
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 16 day Of September 2020 by
this 16 day of September 2020 by
Manuel Tobar
Manuel Tobar
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
^
(Signature f otary
EMI YGALEN
(Signature tary Publi $ "", Florida EMILYGALEN
4•:. )
,: MY CO IS ON # GG 165462
Commission No. 165462 _�: _ ��P
;`, MY COMMISSION # GG 165462
Commission No. 165462 '•�•t •o,' EX 31 ecember5, 2021
EXPIRES'" cember5,2021
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I'Fod i °p` Bonded Thru Notary Public Und®nrrl4ere;
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Bonded Thru Notary Public Underwriter;
K +
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/2U