HomeMy WebLinkAboutBuilding Permit Application 2A/|AP9UCAB /POCOMPLETED FOR APPLICATION TOBEACCEPTED
Date: �' Permit Nu
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Building �°�Uvv�Ung Permit App ication
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie CountY-,-FL
23D0Virginia Avenue, Fort Pierce 834982
Phone: (77Z)4G2'15S3 Fax: (77Z)462'157D ConODlerCi8lR85ideOti�| �~
PERM[T7YPE:Tank and Line
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Address: 7507Palomar Street Fort Pierce R34951
Property Tax 0#: 1301'801'0183-000'8
Site Plan Name: Self
Project Name: Self Generator
WOR
Supply and install 500 gallon 1p tank with gas line to generator and final connect
Lot No. 25
Block No. g
Additional work tobeperformed umderthbpannit—checkaUthatapply:
—Mechanical GasTank Gas Piping Shutters Windows/Doors
__Electric __Plumbing __Sprinklers __Generator ___Roof Pitch
Total Sq. FtufConstruction: Sq. Ft. ofFirst Floor
Cost of Construction: $ t qq5�� Utilities: —Sewer _Septic Building Height:
Name Gary Self
Name: Blake Cowdell
Address: 7507 Palomar Street
Company: Energized Gas
City: Fort Pierce State:
Zip Code: 34951 Fax:
Phone No. 772-465-0419
Address: 1786 SW Biltmore
City: Port Saint Lucie State: Fl
Zip Code: 34984 Fax: 772-332-6672
Phone No 772-466-1095
E-Mail:
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail energizedgenerators@gmail.com
State or County License LG34747
ifvalue ofconstruction is $2SqVn,more, aRECORDED Notice of Commencement is required.
s.�.)4aa;.�
Name: Name: ,`'. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Address: Address:
City: State: City:
Zip: Phone Zip: Phone: State:
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 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFF A )(A(I COUNTY OF _
The forgoing instrument was acknowledged before me The forgoing instr ment was acknowledged before me
this day oft(_ 20L 1 —1 by this day of 20 l9 by
a � " ' rcw Op � I A� ..(—CX_,6Cy �
Name of person making statement. Name of person making statement.
Personally Known X OR Produced Identification Personally Known � ` OR Produced Identification
Type of Identification Type of Identification
Produced Produced
SON
(Sig t ntr
1�€C2'3a (Signatu
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION FR
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COUNTER REVIEW REVIEW REVIEW REVIEW VIEW REVIEW
DATE
RECEIVED
DATE i i
COMPLETED
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