HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:LIJ
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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 tank -�
PROPOSED IMPROVEMENT LOCATION:
Address: 2506 Tamarind Drive Fort Pierce FL 34949
Legal Description: Fort Pierce Shores unit 3 blk 8 lot 3
Property Tax ID#: 142560300040007 Lot No.3
Site Plan Name: Block No. 8
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 500 gallon propane tank with lines to tankless water heater,range/dryer/pool heater and BBQ
CONSTRUCTION INFORMATION:
Additional work to eRj
e orme under this permit—check a apply:
C�HVAC Gas Tank ❑✓ Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: 3 yd4O, 00 S . Ft.of First Floor:
Cost of Construction:$ Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameTerry -4 Name: i
CC
Address: )'1 wa Company: t 6-a5
City: Y Ur'► nn• Ci State: Pj Addre s: r I OyAn
Zip Code: "V Fax: City. St/a�te:2
Phone No. Zip Code: Fax 1 J
E-Mail: Phone ' 7i ��
Fill in fee simple Title Holder on next page(if different E-Mail: nl Q wA,6•LPIY6
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 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
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
commenci ork or recording our Notice of Commencement.
A�.� 44�_FK� K).Vw 4a't'�e
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Signature of Owner/Lessee/ on ractor as gent for Owner Signature C tract LI en
STATE OF FLORIDA STATE OF nT ( , , Ci�� COUNTY OF ORID �� Gc�
COUNTY OF �/�-
The rgoing instrument was acknowledge efore me The for oing instrument was acknowledged before me
this\ day of 1 CdU 20 LLby This V day of 20 1 by
(Namelbi person acknowledging) (Name of p rson acknowledging)
(Signature of Notary Public-State lorida) (Signature of Notary Public-State of lorida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identific tion Produced Type of Identification Produced
Commission No. '°( la Commission No.
Lo Y P4?. Notary Public State of Florida �� °�a Notary Public State of Florida
f{ Antonia M Paula e ��,(� o Antonia M Paula
c ;;C v
Expires 02/27/2019 Y�`of vti15 Expires 02/27/2019 �
Revised 07/15/201�b
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
CO M P LETE
INITIALS