HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �y q
Date: Permit Number: 1� J — 000.5
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Building Permit Application JU 201Yer
Planning and Development Services 7
Ut �y
Building and Code Regulation Division PERMITT114017
2300 Virginia Avenue, Fort Pierce FL 34982 St. LuLa n% L
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResiRftL44
PERMIT APPLICATION FOR: Gas piping
Address: 13306 NW Baywood PI
Legal Description: Riverbend (PB 67-36)Lot 38 13306 NW Baywood PI
Property Tax ID #: 4425-703-0043-000-8
Site Plan Name: StanPac Riverbend Lot 38
Project Name: Lot 38 13306 NW Baywood PL -Ladd- Res
Setbacks Front Back: Right Side: Left Side:
Interior and Exterior LP Gas Lines and Underground tank 250 gallon
Lot No. 38
Block No.
jaitional worK to be
11HVAC
11 Electric
nerrormea
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unaer tnis permit— cnecK ali
Gas Tank W]Gas Piping _
Plumbing Sprinklers El
apply:
Shutters a Windows/Doors
Generator 11 Roof
0
Total Sq. Ft of Construction:
Cost of Construction: $ 5375.00
S Ft. of First Floor: _
Utilities:Sewer []Septic
Name Standard Pacific of FL GP
Address: 825 Coral Ridge Dr
City: Coral Springs State: FL
Zip Code: 323071 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
Name: Cheyenne Ellison
Company: Propane Service Inc DBA Elite Gas Contractgors
Address: 2130 SW Poma Dr
City: Palm City State. FL
Zip Code: 34990 Fax:
Phone No. 772-220-9678
E-Mail: kgehrke@elitegasco.com
State or County License: 18361
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applica
Name: _
Address:
City: _
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
State:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Not Applicable I BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing woWoe'recording your Notice of Commencement.
_ SigKa6rt'of Owner/ Lessbe/Agent
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF NUYAAn I COUNTY OF �A(1,Y-ho
Holder
The forgoing instrumen was a knowledged before me The forgoing instrum t was acknowledged before me
this day of 20 ay this � day of v 20 � by
(Name of person acknowledging) (Name of person acknowledging)
(Sig#urebf-htcJ%F4 Public- State of Florida )
Personally Known Y OR Produced Identification
Type of Identification Produced
Commission No.
Revised 07/15/2014
(Stgnat o tc- tate of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
(Seal) Commission No.
JENNIfAR QHNSON
b -19. 2021
(Seal)
JENNIFERJOHNSON
Expires June 18, 2021
Bonded Thru Budget Notary Services
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