HomeMy WebLinkAboutAPPLICATION (2)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 05.17.2021
GC3(I NT Y
F. L " k f r,
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Fierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: GAS TANK
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential )(,
Address: 7960 PLANTATION LAKES DR PORT ST LUCIE FL
Property Tax ID #: 3321-803-0012-000-7
Site Plan Name: RESERVE PLANTATION - PHASE IIA
Project Name: VASSELL & MOORE
Lot No. 6
Block No,
DETAILED DESCRIPTION OF WORK: I
INSTALL A 1000 GALLON LP TANK AND GAS LINES TO A 68Q, CT, FPLACE, (2) THWH-r GENERATOR
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
—Mechanical 4-Gas Tank 1-Gas Piping T Shutters _ Windows/Doors
--.. Electric — Plumbing —Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 8780.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jason A Moore, Karen L Vassell
Name: PAUL i7RAGH1
Address: 29 Harbour Isle Dr W Unit 306
Company: PAULIE PROPANE & NATURAL GAS SYSTEMS, INC.
Address:4100 SE SALERNO RD
City: Fort Pierce State: FL
Zip Code: 34949 Fax:
Phone No.
City: STUART State: FL
Zip Code: 34997 Fax:
phone No 7721220 2616
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail pauliepropane@gmail.com
State or County License 24441
IT Value oT Construction Is $ZSOO 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:
DESIGNERANGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
Ol�l►NER: OUR FAILURE TO RECORD A NOTICE ENCEMENr MAY RESULT IN YOUR PAYING
FO IMP MENTS TO YOUR PROPERTY. A NOTI E OF C MEN EMENT MUS RECORDED AND
ED O T SITE ORE THE FIRST INSPECTIO IF YOU TO OBTI�NCING, CONSULT
YOUR AIM OIIIIIEY BEFORE RECORDING OUR NO MMM
Signature of Wwner/ Ees�e)NContraytor as Agent for Owner
STATE OF FLORIDA STATIk OF FLORIDA
COUNTY OF M� ARZ COUNTY OF tA4 JkV-Tr Q
The forgoing instrument was acknowledged before me
this —L_lt_ day of 2(7,� by
Name of person making statement.
Personally Known �/ OR Produced identification
Type of Identification
Produced
The forgoing instr meat b�+rras acknowledged before me
this �da of 1,1� 26 J by
,�4 1�41 -
Name of person making statement.
Personally Known ✓ OR Produced Identification
Type of identification
Produced
ILA
(Signature of !Votary Iii� tat�� Q i��? � •., � (Signature of Notary Public obi 41co
Commission No. =* .($pal * Commission No.
y . y #GG 90868E _ �� •• r
.r p••�j �].•C'r y aNN•
REVIEWS FRONT ';.3fi1f Q �RVISQR PI,4N5 VEGETATIt,,'.�gt@fi�ilE •GROVE
COUNTER ' t , ,I '��s;� W EVIEW REVIEW REVIEWu ��e�g •' � EVIEW
DATE
RECEIVED ✓��� ,���C STAi6o���� ��`
DATE
COMPLETED