HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/27/2021 Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMITTYPE:GaS
PROPOSED IMPROVEMENT LOCATION:
Address: 608 Ramie Ln
Property Tax ID it. 3419-515-0088-000-6
Site Plan Name: _
Project Name: Cook
DETAILED DESCRIPTION OF WORK:
1000 qallon tank and line to generator.
CONSTRUCTION INFORMATION:
Residential X
Additional work to be performed under this permit — check all that apply:
_Mechanical ,p Gas Tank XGas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of ConstruchowS 2400,00 Utilities: _Sewer _Septic
Lot No.
Block No.
_ Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Cook Allison Julia
Name -Cheyenne Ellison
Address:608 RAMIE LN
Company: Propane Services DBA Elite Gas Contractors
City: Pon Saint Lucie State: _
Zip Code: 34952 Fax:772-220-1829
Phone No.772-220-9678
Address: 2130 SW Poma Or
City: Palm City State:FL
Zip Code: 34990 Fax 772-220-1829
Phone Nc772-220-9678
E-Mail:lmelende @elitegasco.com
Fill in fee simple Title Holder an next page ( if different
from the Owner listed above(
E-Maillmelendez@elitegasco.com
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: Applicable
Name:
_Not
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 ORAN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.'
Signature ofOwner/ Lessee/Contractor as Agent for Owner
Signature of ntrador/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF MO.s-+i rt
COUNTYOF M(as r}i+1
The forgoing instrument was acknowledged before me
this a -)day of Mail 20-a1 by
The forgoing instrument was acknowledged before me
thisoMdayof VAa4 .20 QI by
QAd PJ/tyUL `Q0 f�tti
C'J,.o t�PJ....tn2 �002FcOw
Name pf p on makingstatement.
Personally Known `/ OR Produced Identification
Name of per n makingstatement.
Personally Known V OR Produced Identification _
Type of Identification
Type of Identification
Prod ed
Produced
ISigna re of N to
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Commission No. .'� Des'vee NMGnlosh
Exo{�NB9m GG 203]99
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(Signature of Notary 9
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Commission No. Commieiim`1iG 203399
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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