Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutBuidling Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 Permit Number:
Building Permit Application JUL
Planning and Development Services ©EI 1ihTi';�
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 St. L uc's--GOUnty, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Gas tank -!
PR()POS'.ED IIVIFROVE.MENTL'OCATION " �� MIN
Address: 12797 Cinnamon Way
Legal Description: Mariner Village Harbour Ridge-Plat 3-Unit 30(Or 1185-744; 3908-1636)
Property Tax ID#: 442560200290004 Lot No.
Site Plan Name: Ozier Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
a „a},c,x A n ;„a"x ,ate w;� rw � iy U i
ERN
„k'. prs
DETAILEDrDESCR'IPTION ®F�UV�ORKr „ �
°.. . _
500 gallon underground LP tank install and line }o gentria.Le— i- Fes r-10.1 Connec+
a +v,.: ' ';, i .m m -'§ eebb�x,y ta� a t
y €" kd.�, '1 1 Yom" Qk N P f 4^y K "y P
CON5TRUCTI®N INF,®RiIVIATI®N n- gX z P M
- s..- ..�,t* roE.a.s. a�.� �.. :M�,.., .tis � +
Additional work toene orme under this permit—check a appy:
HVAC LJ Gas Tank ❑Gas Piping _Shutters Windows/Doors
11 Electric El Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3,400.00 Utilities:n Sewer 0 Septic Building Height:
z t�,„,':' --w fid a n1 _ - La a i C v
OV1lNE'R%LESSEE �.� X11° CONTRACTOR" , .' �.
NameKennethOzier Name: RobertBinkowski
Address:12797 NW Cinnamon Way Company: Energized Gas
City: Palm City State:FL Address: 4252 Bandy Blvd
Zip Code: 34990 Fax: City: Fort Pierce State:FL
Phone No.772-336-8550 Zip Code: 34981 Fax- 772-318-6672
E-Mail: Phone No. 772-877-3440
Fill in fee simple Title Holder on next page(if different E-Mail: ( c► tAai A
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONST 110 1ON LIEN LAW INFORMATI0N�s
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 thepermit 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commendrig,work or recq[dingypur Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI i STATE OF FLOR ,,I
COUNTY OF ©f�.I�l� �{,l�ll-�- COUNTY OF
The f r oing instrument w s acknowledg efore me The f rgoing instrument was acknowledged before me
this day of 20by this J1 day of (. 20 by
(Na of person acknowledging) (Name of pe on acknowledging)
ou U, C t a
(Si nature of Notary Public-Sae of Florida) (Signature of Notary Public-State of F rida)
Personally Known )Q OR Produced Identification Personally Known OR Produced Identification
Type of IdentificatioA Produced Type of Identification Produced
Commission No. a mission No.
Notary Public State of Florida
Antonia M Paula ao P` Notary Public State of Florio—
.
of w Expires 02/27!2019 My Commission FF 191201
Revised 07/15/2014 OFNo?' Expires 02/27/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS