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HomeMy WebLinkAboutPermit ApplicationAll APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date I I �-a-L Permit Number: Plannlnq and 0evelnommf Srrvv,-� Bmldin0 one Code B,qubun•0,:nron 23W Vagimo Avenue Fbrt P,,,e Ft 34982 Phone: 1772) 462.1553 Fax (772)462.1578 PERMIT TYPE:Gas PROPOSED IMPROVEMENT LOCATION: Address: 1507 NW SAWGRASS WAY Property Tax ID R: 4426-815-0060.000-0 Site Plan Name: Pederson Project Name: Pederson Building Permit Application Commercial Residential X Lot No._ Block No. DETAILED DESCRIPTION OF WORK: i Run new gas line from existing pool heater to F.replace CONSTRUCTION INFORMATION: Additional work to be performed under this permit -check all that apply: _Mechanical _Gas Tank ./Gas Piping _Shutters —Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator —Roof Pitch Total Sp. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: S 2400 00 Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: I CONTRACTOR: Address: IS 0-7 N W Sr.w ar a s+ Q d4 n�T'' City: �4�V,r. ci.3 5tateTL Zip Code: 7doiS0 Fax:772-220.1829 Phone No. 772-220-9678 E-Mail:lmelend-@elitegasco.com Fill In fee simple Title Holder on next page I If different from the Owner listed above) Company:Propane Services DBA Elite Gas Contractors Address: 2130 SW Poma Dr City: Palm City State:FL Zip Code: 34990 Fax: T72-220-1829 Phone No772-220-9678 E-Mail jmelendez@eIRegasco.com State or County License 18361 It value Of construction IS>[auu or more, a xtcV xOeo notice of commencement IS req If value of HVAC Is $7,S00 or more, a RECORDED Notice of Commencement Is required. i SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Appl Name: Address: City: State: Zip: Phone MORTGAGE COMPANY: Name: Address: City: �- Zip: Phone:. _ Not Applicable ate: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name:_ I Address: _ Address: City: City: Zip: Phone: zip.. Phone: f 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." i Signature of Owner/ Lessee/Contractor as Agent for Owner SChature ontractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF /l.t'CA►- fi'n The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _ day of 20_ by this � day of A10V. 200Z by Name of person making statement. Name of persQoAnaking statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Pr ed (Signature of Notary Public- State of Florida) (Signature of N ,s• Nniary Putsbe State of Flantua Commission No. (Seal) Commission No. :� O©ereeqNL sp9 EApaes121t112022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/ // 19