HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED , ]
Date: Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Gas tankEl
PROPOSED IMPROVEMENT LOCATION:
Address: 9407 Meadowood Dr, Fort Pierce, FL, 34951
MONTE CARLO COUNTRY CLUB-UNIT ONE-LOT 179 OR 2564-2112
Legal Description: � )
,Property Tax ID#: 1327-801-0068-000-0 Lot No.179
Site Plan Name: Van-Buren Block No.
Project Name: Van-Buren
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
250G undergroud LP tank with lines
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CONSTRUCTION INFORMATION:
Additional work to e ne orme under this permit—check a apply:
1IHVAC L I Gas Tank �✓ Gas Piping _Shutters ❑Windows/Doors
I El Electric 0 Plumbing Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ ZSD 0. w Utilities:RSewer 0Septic Building Height:
OWNER/LESSE-E: CONTRACTOR:
Name Robert Van-Buren Name: Robert Binkowski
Address:9407 Meadowood Dr Company: Energized Gas
City: Fort Pierce State:FL Address: 645 NW Enterprise Dr, suite 107
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-429-0658 Zip Code: 34986 Fax: 772-877-3614
E-Mail: Phone No. 772-877-3440
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: FL34747
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:
1 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 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 ith lender or an attorney before
commencingWork or recording our Notice of Commencement.
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Signature of wner/L ssee/C n c a t for Owner Signature of Contractor/License Holder
STATE COUNTOY OF FLORIDA J l�l� \ ( , p COUNTY `
STATE
OF ORIDAQ_ r,�
The f rgoing instr ent was acknowledged- force me The for�ggoing instrument was acknowledged before me
this day of 20 Uby this -"- day of 20 J2 by
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(Name person acknowledging) (Name o person acknowledging)
CGr/
(Sign re of Notary Public-State f orida ) (Signature of Notary Public-State of Flor a)
Personally Known OR Produced Identification Personally Known OR Produced Identification
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Type of Identification Produced Type of Identificatio P_oducecl
Commission No. P(�Shdstate of Florida Commission No. (Seal)
c� G Notary �
Antonia M Paula
Commission FF 191201 y pAV�U� Notary Public State of Florida
�e OF F1.o4 Expires OtiZ7I7019 � ;�� `. n onla :-�auta
My COMMission FF 191201
Revised 07/15/201 s�W1;toq Expires 02/27i2019
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS