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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ,-1' I Permit Number: REGER Building Permit Application MAR 2 4 2017 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x PERMIT APPLICATION FOR: Gas piping P7flSED )11?F'RYaUEM�IVTrLOCATIQN .�'z P... V . ..,. Address: 12132 Riverbend Rd Port St Lucie FL 34984 Legal Description: Bay St Lucie Lot 16(SUBJ TO ESMT TO C AND SFFCD) Property Tax ID#: 4422-502-0019-000-5 Lot No.14 Site Plan Name: Lot 16 Bay St Lucie Block No. Project Name: Lot 16 Bay St Lucie 12132 Riverbend Rd Setbacks Front Back: Right Side: Left Side: D�ETAILEDkO�SCRIPI-ION�OFIIVORK� ` f � � �� , �Y t l' Interior and Exterior LP Gas Lines and Underground tank 500 gallon �CflNSTRUCTt£�N�lNFflRMATIflN `� r, a i�;melz�'�i a s_..,✓�,.�.% s ., ;u'.,,,,.r.x.�r s>.. .,,,, ',. ...., sA:, ':,,. ..d , ,r% Additional work to be ne orme un er t is permit-check a apply: E]HVAC LJ Gas Tank W]Gas Piping _Shutters a Windows/Doors ElElectric 0 Plumbing Sprinklers El Generator Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ 7350.00 Utilities. —Sewer F—]Septic Building Height: flV1tN ER/ ESE `� �,�� C(7,NTRACTflRr r n Name St Lucie Lot 16 LLC Name: Cheyenne Ellison Address:1655 Breakers West Blvd Company: Propane Service Inc DBA Elite Gas Contractgors City: West Palm Beach State:FL Address: 2130 SW Poma Dr Zip Code: 33411 Fax: City: Palm City State:FL Phone No. Zip Code: 34990 Fax: E-Mail: Phone No. 772-220-9678 Fill in fee simple Title Holder on next page(if different E-Mail: kgehrke@elitegasco.com from the Owner listed above) State or County Licenser 5" If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. g � S!„ ?PLEMENTAL CC}NST�RIlCT1QN Ll �i LAW INF ftMATQN�� 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 qaTWgP,cing,,vnXkor recording our Notice of Commencement. r s _Signature of Owner/Lessee/Agent Sigftattrred-f ontractor nse Holder STATE OF FLOI)ID,�q STATE OF FLOfj��- COUNTY OF �"1��� COUNTY OF 6-t/`(C ;`�- The f instrument was acknowledg�j before me The forPay' nstrument as acknowledged before me thiay of 201�by this EN y of 20 j:'by (Name of person acknowledging) (Name of person acknowledging) Signature of Notary Publ' to of Florida) (Signs re of Notary Public-State of Florida) Personally Known ro uce Idd t'��ff' Personally Known .°'A49,.," ¢�duA�cVft�lfiA 1NSON ALY S A Type of Identificati0 PtOd Type of Identification © 'u. MYCOMMI h'_.. °• -° une 9, 2018 EXPI S dune 9, 2018 Commission No. °•.. �a EXPIR(Ig� Commission No. ��eaf� (407)398-0153 FlonaallotaryService.com Florldallotary Service.com Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS