HomeMy WebLinkAboutFuel.Gas-Patricia Selmer - 6144 Alexandria Cir, Fort Pierce, FL -- ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: LP GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 6144 ALEXANDRIA CIR, FORT PIERCE, FL 34982
Property Tax lD #: 3410-503-0315-000-3
Site Plan Name: SELMER
Project Name: SELMER
DETAILED DESCRIPTION OF WORK:
nstall 250 gallon ug Ip tank and line to the generator
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
—Mechanicai XGas Tank XGas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: S 4400.05
Sq. Ft. of First Floor: _
Utilities: _ Sewer _ Septic
Lot No. 15
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Patricia Selmer
Name: Tom Fite
Company: Ferrell as
Address:6144 ALEXANDRIA CIR
city: Fort Pierce State: FL
Address: 3232 SE Dixie Hwy
Zip Code: 34982 Fax:
City: Stuart state: FL
Phone No. 772-708-8800
zip Code: 34997 Fax: 772-287-3456
E-Mail: sunnypat@comcast.net
Phone No 772-287-4330
_
Fill in fee simple Title Holder on next page ( if different
E-Mail KimWilkins@ferrellgas.com _
from the Owner listed above)
state or county License 31370
Ir Vaiue or construction IS �PZSUU or more, a HtCOMEM0 Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement Is required.
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:
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 priorto the issuance of a permit.
St. Lucie Count makes no representation that is granting a ermit 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 OF Martin COUNTY OF —Martin_
The forgoing instrument was acknowledged before me The forgoing Instrument was acknowledged before me
this __ day ofi 20 by th'—dayof� 20-by
Tom Fite N= T Fite F�tiw a a
Name of person making statement, ¢�ET�•�.po6' o �m f person making statement.
G
�\dgC \SC\ON ytT1, es t�,• oral
Personally Known V OR Pf Ider�>y Ift¢aPti� e�"b � a ally Known V_ OR Pr " 414dery4II.i
='s"�'•a`�''. v� e of Identification =t•"s: aea
Ty ofldentification .. �yy\P,�N�q� yp
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Prod eed ' to= dean Produced�„_� •. _o;
(Signature of Notary Tub"_State of Florida) (Signature of Notary P is -State of Florida)
Commission No. FF063105 _ (Seal) Commission No. FF063105 _ (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED