HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: r' 04
RECEIVED
Building Permit Application :APR 2.0 20V
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 El
PROPOSED IMPROVEMENT OCATION: n { �/
Address: Q 1� a �� U F-I "Iqo
Legal Description:
Property Tax ID#: LAIA 5- - VV L " C)oc)- Lot No. l
Site Plan.Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I
Mrt 54-0 � �a5 1'n e 4'ro rq eX%5! .'fS
r-
o.r%6 ConneL�—
CONSTRUCTION INFORMATION:
Additional work to be ertormed under t is permit-c eckall apply:
EHVAC Gas Tank Gas Piping In Shutters ❑Windows/Doors
Electric F� Plumbing NSprinklers E Generator 0 Roof Roof pitch
Total Sq. Ft of Construction: n S Ft.of First Floor:
Cost of Construction:$ "�� Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name fV1.h aWA-WL Name: Robert Binkowski
Addr�ss(( N 4 Q Company: Energized Gas
City: a6 l State:_ Address: 645 NW ENterprise drive#107
Zip Code: Fax: City: Port Saint Lucie State:FIL
Phone No. Zip Code: 34986 Fax: 7728773614
E-Mail: Phone No. 7728773440
Fill in fee simple Title Holder on next page( if different E-Mail: Antonella@Energizedgenerators.com
from the Owner listed above) State or County License: 34747
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
commencing work or recording our Notice of Commencement.
s
Signatur o Owner/Lessee/Contractor as Agent for Owner Signat re of ontracto /License Holder
STATE OF FLOR�L��J, �� 1 , , „ p�.I/l-' COUNTY OF STATE OF FLORIDA
COUNTY OF VV \ `•C�
The fo oing instru nt`w s acknowledg efore me The fo oing instrument w s acknowledged before me
this-1-->—day of 20by this day of 6'1 20 by
k�q VV �I L -c �k Y4— �M WIS t,11(
(Na of person acknowledging) (Name of pers n cknowledging)
(Signature of Notary Public-State Of Florida) (Signature of Notary Public-State of Florida)
1
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identificatioh Produced
Commission No. (Seal) ommission No. Seal
Public Notary
State of Florida roCS� Notary Public State of�Florida
Antonia N tr a
y' fin commission FF 191201 ''CY �v My commission FF 191201
Revised 07/15/2014 �� Eyoires 0y2712019 oFs�oe Expires 02/27/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS