HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 4
Date: 05/11/2021 Permit Number:
JJ I' RECEIVED
COUNTY
Building Permit Application MAY 12 2021
Planningand Development Service P. rmim-i Department
p s � 9 P
Building and Code Regulation Division St. Lude Count;
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT TYPE:Propane Gas
PROPOSED IMPROVEMENT LOCATION:
Address: 4833 Watersong Way
Property Tax ID#: 2532-500-0023-000-2 Lot No.9
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Install 500 gallon underground propane tank and run line to bbq stub out and home for piping to range.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical h' Gas Tank Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Peter Theodoropoulos Name:Cheyenne,Ellison
Address:4833 Watersong Way Company:Elite Gas Contracting
City: Ft Pierce State:_ Address:2130 sw Poma Dr
Zip Code: 34949 Fax: City: Palm City State:FI
Phone No.561-324-1452 Zip Code: 34990 Fax:
E-Mail:elenitheo@aaol.com Phone No772-220-9678
Fill in fee simple Title Holder on next page(if different E-Mailthoskins@elitegasco.com
from the Owner listed above) State or County License 18361
If value of construction is$2500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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
WITH YOUR LENDER N ATT RNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sign ure of Owner/Lessee/ ntractor as Agent for Owner Signature of EdYtrac r/License older
STATE OF FLORIDA STATE OF FLORID
COUNTY OF /Ii(_a y4i t,%_ COUNTY OF_ XAZ4_✓'H1lo^_
The forgoing instru ent was acknowledged before me The forgoing instrumen was acknowledged before me
this�day of 20,2/by this If day of_ �L1 .20 by
Pp--k-Y 7r-e rg GILD, Co ocx410S C L4 Pv c
Name of person makings atement. Name of petsA makiYOR
tement.
Personally Known OR Produced Identification Personally Known Produced Identification
Typ f Identification Type of Identification
Prod ed Produc
(Signature of Notar (Signature of o a ( c- a g �ari lorida
Y Notary u lie
�p Notary Public Ste of Florida Desiree N McIntosh
Commission No. Desiree Ng a9iish Commission N M Commission GG(�
'� Via• My Commission GG 283399 a a Expires 12H 112022
'+apd� Expires12111/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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