HomeMy WebLinkAboutPERMIT APP - 3-10-21All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/10/21 Permit Number:
•
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
PROPOSED IMPROVEMENT LOCATION:
Address: 9826 Carlton RD
Building Permit Application
Commercial Residential X
Property Tax ID #: 4203-231-0002-000-9 Lot No._
Site Plan Name: DEBUS Block No.
Project Name: DEBUS
DETAILED DESCRIPTION OF WORK:
EXTERIOR LP GAS TANK AND LINES AND INTERIOR LP GAS LINES
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:.
Cost of Construction: $ 5100
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Peter F Debus
Name: Cheyenne Ellison
Address:20700 Glades Cut Off Rd
Company: Elite Gas Contractors
City: Port St Lucie State: _
Zip Code: 34987 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
,-..,'.iouuLuoo a pouu or more, a ntwnutu 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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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
WI OUR LE E OR AN ATTORNEY BEFORE RECORDING Y OTICE OF COMMENCEMENT."
Signatu a of Owner/ Lessee/Contractor as Agent for Owner
Signatur Con ractor/License older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF M 0uq-4-iyL
COUNTY OF &AOt.n/-4-i V\. ,
The forgoing instrument was acknowledged before me
this
-LU day of NA� 20,1 by
The forgoing instrument was acknowledged before me
thisladay of hoc-rC� , 20 i� by
E'U. %r0 ✓-�'
Name of Wson making tement.
Name of per!6 making atement.
Personally Known OR Produced Identification
Ty a of Identification
Personally Known OR Produced Identification
Type of Identification
Priced
Prod add
(Signal re o Dot c- S %ry � Gee of Flonaa
49 Desiree N McIntosh
Commission No. M Corrimisaga3i 293399
Expires 12/7
pP
(Signature of N t r
V ' gk Notary Public Stale of Florida
;9 Desiree N �$
Commission No. yCammwton G'h
4 pdB Expires l2/112022 283388
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2//119