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ALL APPLICABLE INFO /MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /n • I D1 17 Permit Number: ! - 0111__�L
LZASAR
Building Permit Application JUN 12 2T?
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
PERMIT APPLICATION FOR: Gas tank
PROPOSED IMPROVEMENT, LOCATION:
Address: 7424 Laurels PL Port Saint Lucie FL 34986
Legal Description: Parcel 15A at the reserve lot 12(OR 3726-1407)
Property Tax ID #: 3322-501-0015-000-4
Site Plan Name: 7424 Laurels PI
Project Name: Complete -Burton
Setbacks Front-1 0 Back: 10
DETAILED DESCRIPTION OF WORK:
Right Side: 10 LeftSide: 10
Lot No.
Block No.
Installing 500 gallon underground LP tank and line, to generator in accordance with NFPA58
4,,#�0 � f 7bS_' � �d` '
CONSTRUCTION INFORMATION:
Additional work to be bertormed under this permit —check
0HVAC W]Gas Piping
all
apply:
in Shutters
Q Windows/Doors
Gas Tank
_
11 Electric 0 Plumbing
Sprinklers
F Generator
F]Roof Roof pitch
Total Sq. Ft of Construction:
3,700.85
S
Ft. of First Floor:
Cost of Construction: $
Utilities
Sewer Septic
Building Height:
OWNER/LESSEE: Robert Burton
CONTRACTOR: Ferrellgas LP
Name Robert Burton
Name: Jonathan G. Hurd
Address:7124 Laurels PI
Company: Ferrellgas LP
City: Port Saint Lucie State: FL
Address: 3232 SE Dixie Hwy
Zip Code: 34986 Fax: NA
City: Stuart State: FL
Phone No. 772-388-0533
Zip Code: 34997 Fax: 772-287-3456
E-Mail:
Phone No. 772-349-4330
Fill in fee simple Title Holder on next page (if different
E-Mail: katrinabelanger@ferrellgas.com
from the Owner listed above)
State or County License: 02137
If value of construction is $2500 or more, a RECORDED Notice of commencement is regwrea.
SUPPLEMENTAL CONSTRUCTION. LIEN LAW INFORMATION:
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
_ Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name:
State:
Not Applicable
Address:
City: State:
Zip: Phone:
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 work or recording vour Notice of Commencement.
Signature of caner/Lessee/ContfactoT as Agent for Owner Signature o Contractor
STATE O FLORIDA STATE FLORIDA
COUNTY OF Martin COUNTY OF Marun
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this V day of JUM , 2017 by I thisgA day of JV/W- , 20 l7 by
Jonathan G. Hurd) Jonathan G. Hurd
(Name of person acknowledging) (Name of person acknowledging)
(Signatu l(Signature of Notary Public- State of Florida
a of Notary Puic- State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced ����ttr�iNi Type of Identification Produced
FF935405 �\. P•'•\Ss1ONF1 �' mmission No. FF935405 Seal ��`(;•,BE.� /
Commission No. (Sep; �t Zp� g . ) .
ry
Revised 07/15/2014 / e�,G�.•�Q 8-
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REVIEWS
FRONT
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VEGETATION
SEA TURTLE
COUNTER
REVIEW
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REVIEW
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REVIEW
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DATE
COMPLETE
INITIALS