HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/26/2020
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: LP Tank & Lines
PROPOSED IMPROVEMENT LOCATION:
Address: 3109 NW Radcliffe Way
Property Tax ID #: 4425-703-0030-000-4
Site Plan Name: Riverbend
Project Name: Hunter Residence
Permit Number:
RECE�V _D
Building Permit Applicati n Fie
ST. Lucie County, Permitting
Commercial Residential X
DETAILED DESCRIPTION OF WORK:
Install 500 gallon underground LP tank with exterior/underground gas piping
CONSTRUCTION INFORMATION:
Lot No.25
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical ✓Gas Tank _/Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ $ 2,250.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameHunter, Michael & Morgan
Name:Brian M. Critoph
Company:C&C Diversified Services
Address:3109 NW Radcliffe Way
City: Palm City, FL State: _
Address:7954 SW Jack James Drive
City: Stuart State: FL
Zip Code: 34990 Fax:
Phone No.954-695-8053
Zip Code: 34997 Fax: 772-266-4679
E-Mail: morgancmullins@gmail.com
Phone No772-266-4680
Fill in fee simple Title Holder on next page ( if different
E-Mail James@ccdiversifiedgas.com
from the Owner listed above)
State or County License L121079
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
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
_Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Li ense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 26 day of February 20020 by
this 26 day of February 20j?d by
Brian M. Critoph
Brian M. Critoph
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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