HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll 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
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 7848 Carlton RD
Property Tax ID #: 3228-600-0001-000-8 Lot No. --
Site Plan Name: HOMECRETE - TZIMENATOS Block No.
Project Name: HOMECRETE - TZIMENATOS
DETAILED DESCRIPTION OF WORK:
EXTERIOR LP GAS TANK AND LINES AND INTERIOR LP GAS LINES
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical Gas Tank V\GasPiping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4700 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameTzimenatos Lesley
Name: Cheyenne Ellison
Address:624 NE Bent Paddle LN
Company:PROPANE SERVICES DBA Elite Gas Contractors
City: Port Saint Lucie State: _
Address:2130 Poma Drive
Zip Code: 34983 Fax:(772)220-1829
City: Palm City State -FL
Phone No.(772)220-9678
Zip Code: 34990 Fax:(772)220-1829
E-Mail:emcintosh@elitegasco.com
Phone No(772)220-9678
Fill in fee simple Title Holder on next page ( if different
E-Mailemcintosh@elitegasco.com
State or County License 18361
from the Owner listed above)
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
WIT&YIOUR LEND R AN ATTORNEY BEFORE RECORDING YOUR TICE OF MENCEMENT."
Signature Owner/ Lessee/Contractor as Agent for Owner
Signature 41 Contractor/License Holder
STATE OF FLORIDA
COUNTY OF M a+'- I 1 V1
STATE OF FLORIDA
COUNTY OF
The fo oing instrument,was acknowledged before me
this 7dayof C)G(.t1G 20�1by
The for ping instrument Was acknowledged before me
this 3rdayof (JLL/4e .20QIby
CA" t.�wn o -�Fro 1ti.
cj�d Pit" G 71_
Name of PeKsoh making statement.
Personally Known • OR Produced Identification
Name of persQnjnakingtatement.
Personally Known V OR Produced Identification
Type of Identif' ation
Type of Identification
Produced
Produced
(Signature of Notary Public-
op Notary Public State of Florid.ON,V
Commission No. r Rg�irpe N Mclnlosh
'Expires 1211 12 22 283399
pa� Expires 12/11/2022
Inatur e of otary Pub .
Notary Public State of Florltla
mission No. :Q Desir6e,u.�gclntosh
My COmmmut in GG 203399
Q„�� Expires 12/11/2022
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
EIVED
TE
re
MPLETED
V.