HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/6/20 Permit Number:
iCOUNTY
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1S78
Building Permit Application
Commercial Residential X
PERMIT TYPE:GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 7683 Pelican Pointe DR
Property Tax ID #:3522-700-0013-000-5 Lot No.9
Site Plan Name: OAKMONT - ROAF Block No.
Project Name: OAKMONT - ROAF
DETAILED DESCRIPTION OF WORK:
INSTALL EXTERIOR LP TANK AND LINES
TO BBQ. COOKTOP, POOL HEATER
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical < Gas Tank KGas Piping _Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cast of Construction: $ 5400
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameWlliam L Roaf
Name: Cheyenne Ellison
Address:19008 SE Loxahatchee River RD
Company: Elite Gas Contractors
City: JUPITER State: _
Zip Code: 33458 Fax:
Phone No.(772)220-9678
Address:2130 Poma Drive
City: Palm City State: FL
Zip Code: 34990 Fax: (772)220-1829
Phone No(772)220-9678
E-Mail:emcintosh@elitegasco.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailemcintosh@elitegasco.com
State or County License 18361
If value of construction is 5Z5ou or more, a newrcucu rvonce o. Cuunnc....cu.o.,..� ._��,.�-•
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I 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
City:
Zip:
Phone:
Address:
Zip:
OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby mane co oocam a Pcnmr 1--u .1._ ••"-�•••--••-•• __..._._____.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counttflflyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
structure. Pleasecconisult withh any yourHle Home Owners ome Owners Association land reviewrulyyour ws or
for any restrictions nts may
h which restrict
may aor . prohibit such
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
BEFORE RECORDING YOU OTICE OF CO MENCEMENT."
WITH YOUR LEND E OR AN ATTORNEY
F�Si_gnatu&fof Owner/ Lessee/Contractor as Agent for Owner
Signature of ontractor/License Holder
OF FLORIDA
STATE OF FLORIDA
Y OF ICAO r 1i n
COUNTY OF bilar47410
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _(V day of NoVEM)neK , 20,,a0by
this SQ day of Novemtne - 20mloby
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NameName omaking s tement.
Name o erson making atement.
Personally Known � OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
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Pr duced
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(Signatur�0"
0, Notary Public State of Florida
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