HomeMy WebLinkAboutGALE APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:,. Permit Number:
O
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax I D #: '' _s �—}� �; Lot No.
Site Plan Name: Block No.
Project Name:•�`�
DETAILED DESCRIPTION OF WORK:
L L
sn n ecieunx_ ,
r
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical Las Tank as Piping _ Shutters Windows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: _ Sewer _ Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR: r.as
Name, l\ �� ..iC"
Name:
Address: ) ( c
Company. n'a
City: - State:
Address: ,
_
Zip Code: ��� _ Fax:
City: State:
Phone No.
` l
Zip Code: Fax:
E-Mail:
Phone No —
Fill in fee simple Title Holder on next page ( if different
E-Mail'`,CI
from the Owner listed above)
State or County License-�
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.
SJUNP ,,, IENTAL 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 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 work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
_
STATE OF FLORIDAA
COUNTY OF t
STATE OF FLORIDA
COUNTY OF
S orn to (or affirmed) and subscribed before me of
L�Physical Presence or Online Notarization
Sworn to (or affirmed) and subscribed before me of
16 �ysical Presence or Online Notarization
this kLclayof , 2026 by
this xlay of 2020` by
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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
,t
(Signature o Notary Public- State of Florida)
(Signature of Notary Pub ic- State of Florida )
Commission No. vcQta� TEN uR!E-:.ANo
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Commission No. L-oy MARI E F011a�:.ubde
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SUPERVISOR
REVIEWS
FRONT
PLANS
VEGETATION
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20
BOARD OF
COUNTY
COMMISSIONERS
PLANNING & DEVELOPMENT
SERVICES DEPARTMENT
Building and Code Regulation
Division
GAS PIPING SCHEMATIC
[A2] [A4] [A6]
[1_4] [1_8] [1_12]
TANK Ll L3 L5 L7 1_9 1_11
SIZE
L2] [L6] [1-10]
[Al] [A3] [A5]
TANK SIZE: GALS.
APPLICANCE — TYPE/SIZE
Al
hTV-
A2
A3
A5
W's
1 (1`'� 1� aru
-� BTU
CA
BTU
BTU
BTU
BTU
PIPING LENGTH & SIZE
_
L1 FT. INCH DIA.
L2 r
FT.
,-,,INCH DIA.
L3
FT.
. L(INCH DIA.
L4 � (
FT.
_3,&" INCH DIA.
L5
FT.
INCH DIA.
L6
FT.
INCH DIA.
L7
FT.
INCH DIA.
L8
FT.
INCH DIA.
L9
FT.
INCH DIA.
L10
FT.
INCH DIA.
L11
FT.
INCH DIA.
L12
FT.
INCH DIA.
Revised 7/22/14
(PIPE SIZE WAS TAKEN FROM
THE 2014 FBC FUEL GAS CODE —
TABLE 402 ( ))
Website: www.stlucieco.gov
2300 Virginia Avenue - Fort Pierce, FL. 34982-5652
Phone (772) 462-1553 FAX (772) 462-1578