HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COM
Date:
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FOR APPLICATION TO BE ACCEPTED '7 /� l�
Permit Number: I - 0/`i
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Building Permit Application Str 10 2017
Planning and Development Services PERM17TING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Gas piping E-
PROPOSED IMPROVEMENT LOCATION:
Address: 3037 NW Radcliffe Way Palm City FL 34990
Legal Description: Riverbend PB 67-36 lot 43
Property Tax ID #: 4425-703-0048-000-3 Lot No.43
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install gas line from existing tank to generator
CONSTRUCTION INFORMATION:
ACIaitional work to be nprtormed under this permit - check
11HVAC Gas Tank R]Gas Piping
all
apply:
_ Shutters
❑ Windows/Doors
11 Electric Plumbing
Sprinklers
Generator
E] Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 695.00
Utilities:i
Sewer
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJoseph Abromovitz
Name: Robert Binkowski
Address:3037 NW Radcliffe Way
Company: EnergizedGAs
Address: 4252 Bandy Blvd
City: Palm City State: _
Zip Code: 34990 Fax:
City: Fort Pierce State: FL
Phone No.
Zip Code: Fax:
E-Mail:
Phone No.
E-Mail: Antonella@Energizedgenerators.com
Fill in fee simple Title Holder on next page (if different
State or County License: 34747
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
N a1 e: Joseph Abromovitz
N am e: Robert Binkowski
1m
Add ress:3037 NW Radcliffe Way Palm City FL 34990
Address: 3037 NW Radcliffe Way
City: Palm City State:
City: FortPierce State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Ad d ress: 4252 Bandy Blvd
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 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin rk r recording our Notice of Commencement.
A&P
Signa re o Owner/ Lessee/ ntractor as Agent for Owner
Signature 6f Contractor/License Holder
STATE OF FLORIDA,.
STATE OF FLORIDA
COUNTY OF�M'&COUNTY
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OF � d
The forgoing instr ent was cknowled before me
this day of � 20" by
The for oing instru ent was acknowledged before me
this � day of 4 . 20AI by
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Name of p on making statement
Name of perAn making statement
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Personall Known � OR Produced Identification
Personally Known OR Produced Identification
f entificati n
Type of,
Type of I ntification
Produc d
Produc
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(Signa a of Notary P
(Signature of Notary Pub'
Vat Notary Public State of Florida
Commission No. Anton(94�1i'aula
, ' Notary Public State of Florida
Commission No. '� �., ^„ AntoVIaula
+�1� My Commission FF 191201
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17