HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/13/22 Permit Number:
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
PROPOSED IMPROVEMENT LOCATION:1401 Lone Pine DR
Address: 1401 Lone Pine DR
Property Tax ID #: 3409-505-0023-000-1
Site Plan Name: CORNETT
Project Name: CORNETT
DETAILED DESCRIPTION OF WORK:
EXTERIOR LP GAS TANK AND LINES AND INTERIOR LP GAS LINES
Lot No.18
Block No.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit— check all that apply:
_Mechanical ( Gas Tank 12 Gas Piping _ Shutters
_ Electric _ Plumbing _`Sprinklers _ Generator
Total Sq. Ft of Construction:.
Cost of Construction: $ 2400
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameKelley R Cornett
Name: Cheyenne Ellison
Address:1196 Country Gardens LN
Company: PROPANE SERVICES INC. DBA Elite Gas Contractors
City: Fort Pierce State: _
Zip Code: 34982 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 vame or construction is p&)uu or more, a KtcuKutu 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: -�
City:
Zip:.
Phon
FEE SIMPLE TITLE HOLDER:
Name:
Not
State
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Not Applicable I BONDING COMPANY: _Not Applicable
Aaaress: I Address:
City: I City:_
Zip: Phone: I Zip:
U1NNtK/ LUN I KALI UK 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 09 THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH XOYR LENDER OR AN ATTORNEY BEFORE RECORDING YO111RAllOTICE OF OM ENCEMENT "
Signa ure of 91 ner/ Lessee/Contractor as Agent for Owner
Signa ure of C tractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF AA Lrfir7
COUNTY OF Mar%'rt
The for oing instrurrpt was acknowledged before me
day
The for oing instrument was acknowledged before me
this/ of c1 Ct . 20 c7oi by
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Name of Wson making statement.
Name of perso aking s atement.
Personally Known V OR Produced Identification
Personally Known OR Produced Identification
Ty e of Identification
Typ of Identification
Pro ced
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(Si ure of NotaWREVIEWREVIEW
(Signature of Notary c- St to of Florida )
blic State of FloritlaCommission
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Commission No.
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DATE
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DATE
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