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HomeMy WebLinkAboutBuilding Permit Application - Horton-117 Queen Eugenia Ct All 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: 117 Queen Eu enia Ct Hutchinson Island, FL 34949 Property Tax ID#: 1414-701-0050-000-1 Lot No. Site Plan Name: Horton/Stubbs Block No. Project Name: Horton/Stubbs DETAILED DESCRIPTION OF WORK: Install 500 gallon LP tank and line to enerator and grill. CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: Mechanical XGas Tank XGas Piping _Shutters _- Windows/Doors _Electric ^Plumbing Sprinklers r,Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction;$ 5684.05 Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name__Benjamin Horton Name: Tom Fite Address:_117 Queen Eugenia Ct � company: Ferrellgas city: Hutchinson Island State: FL Address: 3232 SE Dixie Hwy Zip Code; 34949 Fax: city; Stuart state: FL Phone No. 772-359-6447 Zip Code: 34997 Fax: 772-287-3456 E-Mail: ben.horton@yahoo.com Phone No 772-287-4330 Fill in fee simple Title Holder on next page 4 If different E-Mail KimWilkins!2ferrellgas.com from the Owner listed above) state or County License 31 370 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. DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: Stater 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 priorto the issuance of a permit. St. Lucie Count makes no representation that is granting a permit will authorize the ermit holder to build the subject structure which is In con'ict with any applicable Home Owners Association rules,bylaws or anscovenants 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.' Signature of Owner/Lessee/ ontractor as Agentfor Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Martin COUNTY OF Martin T_ The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 11 th day of June 2021 by this 11th day afJune 2021 by Tom Fite Tom Fite v Name of person making statement. Name of person making statement. �a"' Personally Known. OR Produced Identification !ilirsonally Known V_OR Produced Identifi Type of Identification �\4�\0�:,,00 of Identification Pr ced I � C��\O� oei2��a. (Signature of Not Public-State of rida 4'Q4r� (Signature of Notary lic-Scat ;a ,g Commission No. FF06310 Commission No. FF063105 REVIEWS FRONT ZO SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE .RECEIVED EE DATE COMPLETED ev. _