HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVE®
�y Building Permit Application JAN�'Q I Z.017
Planning and Development Services
Building and Code Regulation Division Lucie County,
FL
2300 Virginia Avenue,Fort Pierce FL 34982 St.Lucie County,
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Gas tank i=1
PROPOSED IMPROVEMENT LOCATION:
Address: 5319 Keel Way Fort P{fierce FL 34949
Legal Description: Ocean resorts cooperative site214
Property Tax ID#: 1410-510-0214-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:'
Install 120 gallon above ground propane tank with gas lines to range, tankless waterheater and stub
I
ut for BBQ outside kitchen
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all that apply:
EIHVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing O Sprinklers Generator Roof Roof pitch
'Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 1400.00 Utilities:cnSewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameCarl Anderson Name: Robert Binkowski
Address:5319 Keel Way Company: Energized GaslNC
City: Fort Pierce State:FL Address: 645 NW ENterprise Drive#107
Zip Code: 34949 Fax: City: Port Saint lucie State:FL
Phone No. Zip Code: 34986 Fax: 7728773614
E-Mail: Phone No. 7727778133
Fill in fee simple Title Holder on next page(if different E-Mail: Antonella@energizedgenerators.com
from the Owner listed above) State or County License: 34747
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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
An 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
commencipMwork or recording our Notice of Commencement.
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'Signature of Owner/Lessee o ractor as Agent for Owner Signature of Contractor/License Frolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFSaint Lucie COUNTY OFSnlntLucie
The oing instr.,4ment was acknowledg before me The forgoing instrument was acknowledg before me
this day of 20�y this 15 day of December 20 LLD by
Robert Blnkowski 1 Robert Blnkowski
(Nam f person acknowledgi ) (Name erson acknowledging)
(Signature of Notar P lic- to of Florida) (Signature of Notary Pu ' -State of F Ida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identifica 'on Produced Type of Identificati n Produced
Commission No. a Commission No. (Seal)
Ft
e, Notary Public State of Florida
Antonia M F'aula Pie Nory Public State of Florida
OF EV Expires 02/27/2019 0 .{' : nto d
Revised 07/15/201 , NlyCes(321 7/2AnU 1 191201
� Expires o2121f2019
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