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HomeMy WebLinkAboutGas Permit for Permit 2102-0320All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED v v Date: Permit Number: o , © 0��.a �i Building Permit Application Planing and Development Services Building and Code Regulation Division / 2300Virginia Avenue, FortPierceFL34982 Commercial Residential ✓ Phone: (772) 462-1553 Fax: (772) 462-1578 PERMITAPPLICATION FOR: GGS W br 1< Address:. 1 a la I Property Tax ID #: Site Plan Name: _ Project Name: New Electrical Meter -ooa(-oco-a Second Electrical CONSTRIICTION'1NFORMATION: Lot No. Block No. Additional work to be performed under this permit — check all that apply: _Mechanical GasTank ✓Gas Piping _Shutters — Windows/Doors _ Pond _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: a0 Cost of construction:$ yti00'-' Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Syies In Name:.gab&r+ 1WHAQ,`j' Address:... 12164 Sbvth St K14fArbella I Moe Company:_9,":Y J3nlota� I U C Address:IN41 10 1th Ql pCe Wr-4h City:_PSL State: FL ZipCode:349g9 Fax: Phone No. City:,Wft State:M Zip Code:33yI? Fax: Phone No 5(01- 333' 3313 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail 9t13GO5 & C101 • com State or County License LT 1500 w ar more, a nccunueu rvovce or commencement is required. If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEM Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: — Not Ap Name: plicable MORTGAGE COMPANY: _Not Applicable Address: City: State: ZIP: Phone: BONDING COMPANY: Not Applicable City: Address: Zip: Phone; City: Zlp Phone; OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that noworkor Installation has commenced prior to the Issuance of a permitp which (s In contllct with any applicable iHome Owners Asssociation r les abylawszor and covenams that may restrictbor 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 paying twice for improvements to your property. A Notice of Commencement must be recorded in the public records of St. Lucie County and posted on the jobsite before the first Inspection. If you intend to obtain financing, consult with lender or an attorney before commencing wnrle r _ Spad; /r uwne /Contractor as Agent for Owner '���dr r/License Holder STATE OF FLORI J STATE OF FLORI COUNTY OF � �( �C COUNTY OF —LA x ((; Sworn to (or affirmed) and subscribed before me of hysical Pre a ce or Online Notarization this 1"7 day of 202Q by L Name p rson making statement. Personally Known � OR Produced Identification Type of Identification Sworn to (or affirmed) and sub rlbed before me of _Physical Prese e r Online Notarization this day of 202� by P Name of person making statement. ersonally Known OR Produced Identification Type of Identification of No. l_6.� C- r public State of Flori aCo mission No. �^, Jennifer A Schillinger �J�Y 6Ng,- Nolary Public Sl �h j( JennilerAScl "�_- P My Commission Ezpi 3s 10/08/2023