HomeMy WebLinkAboutBLDG PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
!COUNTY
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 x
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT" TYPE: LP GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 2744 Brocksmith Rd Fort Pierce FL 34945
PropertyTax lD #: 2320-501-0056-000-4 Lot No.
Site Plan Name: Roche Block No,
Project Name: Roche
DETAILED DESCRIPTION OF WORK:
Install 500 gallon ug Ip tank and line to generator and water heater.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical XGas Tank XGas Piping _ Shutters _ Windows/Doors
— Electric _._. Plumbing _ Sprinklers Generator _ hoof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 6470.50
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Miriam Roche
Name: Tom Fite
Address: 2744 S Brocksmith Rd
city: Fort Pierce State: FL
Zip Code.. 34945 Fax:
Phone No. 561-762-7141
E-Mail:mroche@bellsouth.net
Company: Ferrell as
Address:3232 SE Dixie Hwy
City: Stuart state: FL
zip Code: 34997 Fax: 772-287-3456
Phone No 772-287-4330
E-mail KimWilkins@ferreligas.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
-
State or County License 31370
It value of construction Is SZ500 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.
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 priorto the issuance of a permit,
St. Lucie Count 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 Associaton 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 A ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM NCEMENT."
Signature ofContractor/License d er
Signature Owner/ Lessee/Contractor Agent for Owner
of as
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin --
gill lll
The forgoing instrument was acknowiedl��le/4/��
this10tYldayof March^. y �k/>i,
The for oing instrument was acknow���$L1dlUilfgf� fne
-thls10tidayotMarch---
SSION '°'•'I'S //i
a \°i r
E;
� �•t/ �/
�14`,•• \SSION 2S rrr
Tom Fite �o `�9ER2B,?gym
Tom Fite �: o seRz°%' _
Name of person making statemenE e oa— �
Name of person making stat=eni •4 6'�-
Personally Known OR ProE'yc dlplen$) cation �.' Q
Personally Known 0$Prm cet gM&atio7
Type Identification "' p•:
Type of Identification ��o'•.°.ayeonded\�g4,
Produced %'�Ry ?u6IIcUnB.•rF
of a g �mH
Produc d^_
_ Y// IUD,
l g 0�1141l1 �o�`��`
(Signature o Notary P I. c- State of Florida)
(Signature of Notary P lic- State of Florida)
Commission No. FFO 3105 (Seal)
Commission No. FF063105 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
.RECEIVED
DATE
COMPLETED
Rev. Z///19
�' Ferrellgas
ID 56040898
Doug Kelp ,II'
Account Manager
772 216-2656 cell 772 287.3456 fax j
dougke'ora]tanelldasCom ',
Miriam Roche
Date: 14-Feb•22
2744 S Brocksmlth Rd Purchase 500 UG LP Gas Tank
Ft Pierce FL 34945
mroche(@belleouth nel
Phone 661.702-7141
To Install:
Sale and installation of 500 gallon underground LP tank and gas line to generator and wat!r heater.
Proposal Is subject to site check and must meet all state and local Codes
500 Gallon Propane Tank
UG Installation
Ext. Line up to 30' of gas piping
Int Line up to 00' of gas piping
Final Connect and 2 outlets
Regulators
Sub Total
Tax
Permit
TOTAL
$ 3,100.00 •sate
$ 1.350.00 •Anchor.yaromend.mdahWhosid
$ 450.00 •Minimum 44450.00etldMom1parhato
'Mlnlmun or dd50.00 "e Beare per loot
$
s.ary cheek shorebird up
325.00
$
425.00
Regulleq ehotuH Volvos. Rion, sic.
$
51660.00
7.00% $
395.50
$
426.00
ayeadcaW.
$
6,470.50
Tank x appliance loralimns must compty with all able 6 rocal oes aM "IMin9 codes.
$ 12.50
$ 14,50
e A -be aurvay leMbeauppllld by lM customer fee pemded,parposes, ilwm is da Mlnblam aAmwoNs pared mod" ror pamlh prot,aslnp Plans lM date Me damsk
a requlrsd documents dark rosolvadl paler to amy work tall, paa m., an.1
• R.wlalam made alter permlling will require an"dklonal 31 weeks forprocessing a them will be addlool Ching...
Farrell le nW r.,dre ibb for damage to aid Plga or lines hncluolmg Irrigation, shrill, alc,l not marked by control mining wrac.. Homeowner Is m.mnsible to
mark their own sprinkler or low voltage Imes
• calendars %nabmaWhslbts for plammal or physical adjustment of.p Plm,r.s,
• camellias is not responslblo for damage to or repecement of landscaping, c.n ale sidewalks Cr any aledricel.
• Customer is responsible lnrpmvlding labor and conversion kit mdonor" edyges appliance for use of propane.
• Generators ma requlmd to have s Mrlole line to Wnn.d toga.
• Customo'smetld Most beapproved pnor to commencement of any work.
[ruled, urges Imes to be done by others.
UrmMmund tanks includes Wlh"Ic protection.
A 0% dePosk Is due upon acteptanm. A m% c.Mw kumm parson, as apply
Please sign if... have lead is afire. 1. the freedom,
The undersigned agrees Ihl In the award date become
for any S all Morey lase m ssyre�-C61TdL, al
Ferrellgas Signature; /y
Wall for 00 days subject to Mo. dlling soft, someone,
W almd, that Me Undersigned shill be mspa .ibis to Permlees LP
Date: o�.'Y �"-
Date:
Contact Information
Penny Randall Administrative idermyrandadMieffedloasi.conin
Kim Wilkins Permiffing kmwUk'nsl®fetrel_ b�
Jane Conner Scheduling 1 rtmk jigs
3232 SE Dixie Highway, Stuart FL 34997