HomeMy WebLinkAboutFuel.Gas-Florida Mentor-111 NE Caprona Ave-Signed AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY
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
PERMIT TYPE: LP GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 111 NE CAPRONA AVE, PORT ST LUCIE, FL 34984
Property Tax lD #: 3419-530-0238-000-0
site Plan Name: CAPRONA AVE GROUP HOME
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALL 500 GAL UG LP TANK AND LINE
CONSTRUCTION INFORMATION:
Lot No. 16
Block No. 40
Additional work to be performed under this permit —check all that apply:
_Mechanical XGas Tank XGas Piping _ Shutters _ Windows/Doors
-,,,, Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5256.05
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Capgrow Holdings JV Sub VI LLC
Name: Tom Fite
Address: 320 W Ohio St Ste 650
company:_Ferrellgas
_
Address:3232 SE Dixie Hwy
city: Chicago State: IL
Zip Code: 60654 Fax:
City: Stuart state: FL
Phone No. 772-341-0914
Zip Code: 34997 Fax: 772-287-3456
Phone No 772-287-4330
E-Mail: HeidiGrosso@TheMentorNetwork.com
Fill in fee simple Title Holder on next page ( if different
E-Mau K!mWilkins@ferrellgas.com
from the Owner listed above)
State or County License 31370
It value of construction Is 52500 or more, a RECORDED 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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
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.
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, wails, 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 AIWATI'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMWNCEMENT."
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 9th day of April 2021 by
this 9th day of April 20 21 by
Tom Fite
Tom Fite
Name of person making statement.
Name.of person making statement.
Personally Known ✓ OR Produced Identification .
Personally Known ✓ OR Produced Identification- '
Type of Identification
Type of Identification-
Produced
Produced
(Signature of Notary Pu c- State of Florida j
(Signature of Notary P lic-%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
Rev, 2/7/ 19