HomeMy WebLinkAboutPERMIT APPLICATIONSUPPLEMENTAL 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
is in any Home Owners Association rules, bylaws or and covenants that may restrict or such
which conflict with applicable prohibit
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
wrr&YQ6R LE ER OR AN ATTORNEY BEFORE RECORDING YORPIOTICE OF COMMENCEMENT."
Signature wner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDQ,q
STATE OF FLORIDA
COUNTY OF /4&-r_�PL_
COUNTY OF '► ¢��
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this A day of DC;#LD%-ems , 20 a by
this U day of Df,4DIp44- . 20 oZ( by
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Name of pegon making statement.
Name of peOcifn making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Pr ced
Produ d
(Signature Of No -
(Signature of N
aJM • Notary Public State o/ Floritla
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Expires 12/11/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
E
EIVED
E
F
PLETED
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10-21-2021
Permit Number:
;J
•
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
PERMITTYPE:GAS PROPANE
PROPOSED IMPROVEMENT LOCATION:
Address: 9304 sCARBOROUGH CT
Property Tax ID #: 3322-507-0020-000-0
Site Plan Name: MASSIMO TRIPODI
Project Name: MASSIMO TRIPODI
DETAILED DESCRIPTION OF WORK:
RUN GAS LINES TO POOL HEATER AND FIRE FEATURE
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:.
Cost of Construction: $ 1600
Gas Piping _Shutters
_ Sprinklers _ Generator
Sq. Ft. of First Floor: _
Lot No.15
Block No. POD 12.13
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
NameMASSIMO TRIPODI
Name:CHEYENNE ELLISON
Address:9304 SCARBOROUGH CT
Company: PROPANE SERVICES DBA ELITE GAS
City: PORT ST LUCIE State: i L
Zip Code: 34986 Fax:
Phone No. 772-979-0793
Address:2130 SW POMA DR
City: PALM CITY State: FL
Zip Code: 34990 Fax:
Phone No7723414808
E-Mail:MAXIMIZED2006@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailTHOSKINS@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.