HomeMy WebLinkAboutBUILDING PERMIT APP - 12-10-20All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/10/20
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Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:GAS
I PROPOSED IMPROVEMENT LOCATION:
Address: 109 NE Charleston Oaks DR
Property Tax ID q: 3409-601-0007-000-8
Site Plan Name: HOMECRETE - EVANS
Project Name: HOMECRETE - EVANS
DETAILED DESCRIPTION OF WORK:
Permit Number:
Building Permit Application
Commercial Residential x
EXTERIOR LP GAS TANK AND LINES AND INTERIOR LP GAS LINES
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Lot No.4
Block No.
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 5200
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJames Evans
Name:Cheyenne Ellison
Address:9713 NW 42nd CT
Company: Elite Gas Contractors
City: Sunrise State: _
Zip Code: 33351 Fax:(772)220-1829
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 52500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 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:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 IMPROYEMENTS 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature f Owner/ Lessee/Contractor as Agent for Owner
Signature of 10ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MUy-4; n
COUNTY OF Mari -in
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this JQday of bCCeyY1J02.r,20apby
thisMdayof noi?�ingr .20_Qpby
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Name o erson makin statement.
Name of p rson makin statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
ProducE
Produced -
(Signature of N
(Signature of No
ao�r •o•k Notary Public Slate of Florida
Commission No Desiree N M"IN "A
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Commission No. �° Desiree N Mcl��l
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REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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