HomeMy WebLinkAboutBuilding Permit Application - Guba All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
rOIU111fi
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential xx
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Gas tank and Gas line Installation
PROPOSED IMPROVEMENT LOCATION; 3312 NW Perimeter Road Palm GityFL 34990
Address: 3312 NW Perimeter Road Palm City, FL. 34990
Property Tax ID#: 4436-510-0026-000-5 Lot No. 22
Site Plan Name: Philip Guba Block No.
Project Name: Philip Guba
DETAILED DESCRIPTION OF WORK:'.
Installation of a 500 gallon tank with 25'of gas line to a generator
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical Y Gas Tank Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3,999.00 Utilities: _Sewer _Septic Building Height:
OWNER LESSEE: CONTRACTOR
Name Philip P Guba Name: Dean Schneider
Address: 3312 NW Perimeter Road Company: Como Oil and Propane
City: Palm City State:_ Address: 1701 commerce ave
Zip Code: 34990 Fax: City: Vero Beach State:FL
Phone No. 317-414-5257 Zip Code: 32960 Fax:
E-Mail: philippaulguba@gmail.com Phone No 772-562-6666
Fill in fee simple Title Holder on next page(if different E-Mail daniellez@comoflorida.com
from the Owner listed above) State or County License 31431
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
7-7
ot`Appli abMORTGAGE COMPANY: Not Applicable
' lame; Name:
Address: Address.
City: State: City: State:
Zip: Phone Zip: Phone
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: -Not Applicable
Name: Marne:
Address: Address
City:. City:
` Zip Phone: Zip: Phone:
I
O CONTRACTOR AFFIDVIT. Application is thereby 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 snakes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Horne owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Horne 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 pasted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commet ci vas€ rk or recording your Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for owner Signature of Contra or/License older
STATE OF FLORDA STATE OF FLORIDARI
COUNTYF ,nC�1cx� y - t OFF, yNkC�`� �'�''`
Sw rn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization ,Physical Presence or online Notarization
this day of 202t by this day of 202t by
-02L l 6
Nance of persola snaking statement. Marne of person snaking statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification l Type of Identification
Pr ced— )-L___ Produced
(Signature of Notary Publi F ill# LE P. ;i nature of Kota P l FIc I LLE F ZIh.�MERP,1AN
z° ,State o Florda-Notary Pobli
;r° ` ,State
Commission # GG 141634 of Florida-Notary P bli
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'c o ;s GG 141634
rCommission No. vS nmission Expires Orni5Sitn NO.
September 09, 2021 ",O �P; M esm;ss;on Expires
y
September 09, 2071
REVIEWS FRONT ZONING SUPERVISOR PLAINS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
BATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20