HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
•i NO
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
Commercial Residential X
PERMIT TYPE:GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 3046 NW Radcliffe WAY Palm City, FL 34990
Property Tax ID #: 4425-703-0018-000-4
Site Plan Name: MELIANS
Project Name: MELIANS
DETAILED DESCRIPTION OF WORK:
EXTERIOR LP GAS TANK AND LINES TO POOL HEATER
I CONSTRUCTION INFORMATION:
Lot No.13
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical WGas Tank UGas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2400
Sq. Ft. of First Floor:
Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Santiago Gabriel Melians
Name:Cheyenne Ellison
Address.3046 NW Radcliffe WAY
Company: PROPANE SERVICES INC. DBA Elite Gas Contractors
City: Palm City State: _
Zip Code: 34990 Fax:(772)220-1829
Phone No.(772)220-9678
Address:2130 Poma Drive
City: Palm City State: FL
Zip Code: 34990 Fax: (772)220-1829
Phone No(772)220-9678
E-Mail:emcintosh@elitegasco.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailemcintosh@elitegasco.com
State or County License 18361
It value of construction is 52500 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, 1 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 Y LENDER CIO AN ATTORNEY BEFORE RECORDING YOUR NOTACE OF COMMENCEMENT:"
Signature of O ner/ Lessee/Contractor as Agent for Owner
Signatur Contr or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF l'1/LAr-B^
COUNTYOF /Liatvf�[n.
The for cling instrument was acknowledged before me
this / day of �fUI'n%.ly , 20&' [ by
The for cling instrument was acknowledged before me
this I day of vi�n i , 20by
(��-1:c le.�th e �D�a�nvl
GLtt�.ee P 1Ws-a
Name of p r n making statement.
Name of persto,6 making statement.
Personally Known OR Produced Identification
Personally Known tr OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of otary Pu i n
gar p` Notary pu lic State o1 Floritla
Commission No. F Desir��Ce N�� clntosh
My Cdd�d+74 ion GG 283399
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(Signature of No
�'rn.y` Notary public State of Florida
`F
Commission NO. Desiref��jj¢¢IntOsh
My Co 451oh GG 283399
Expires 12/11/2022
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