HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
I;ECC- IVED
Building Permit Application SEP 1 6.2017"
Planning and Development Services
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Gas tank
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PROPOSEDIM�PROUEMENT LOCATIQN °.,t
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Address: 5409 Eagle Drive Fort pierce FL 34981
Legal Description: Holiday pines S/D Phase 11-13 lot 273
Property Tax ID #: 131280100760003
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
install 250 underground liquid propane tank with line to generator
EIHVAC LLJ Gas T
Electric
Total Sq. Ft of Construction: _
Cost of Construction: $ 2295.00
0 Plumbing ❑Sprinklers
I l Shutters
11 Generator
S Ft. of First Floor: _
Utilities. Sewer ElSeptic
Lot No.279
Block No.
QWindows/Doors
E] Roof Roof pitch
Building Height:
01N�NER/LESSaEE�
fl �� .. .4,..,
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14+
CONTRAaOR �.
_
NameDonald Johnson
Name: Robert Binkowski
Address:5409 Eagle Drive
Company: Energized Gas INC
City. Fort Pierce State: _
Address: 4252 Bandy Blvd
Zip Code: 34981 Fax:
City: Fort Pierce State: FL
Phone No.
Zip Code: 34981 Fax: 7723186672
E-Mail:
Phone No. 7727778133
Fill in fee simple Title Holder on next page (if different
E-Mail: Antonella@EnergizedGenerators.com
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.
NGINEER: _ Not Applicable
Name: Donald Johnson
Address: 5409 Eagle Drive Fort pierce FL 34981
City: Fort Pierce State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Ad d ress: 4252 Bandy Blvd
City:
Zip:
Phone:
MORTGAGE COMPANY:
N a me: Robert Binkowski
Address: 5409 Eagle Drive
City: Fort Pierce
Zip: Phone:
Not Applicable
State:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordine vour DFotice_ of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of C ntractor/License HOlder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF-1--
COUNTY OFUML.aa
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 14 day of August 20_ by
this 14 day of August
20_ by
Robert Binkowski
Robert Binkowski
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 n
Produced
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(Signature of Notary PTMr7�1j%LI:.'Anto
(Signature of Notary Publi
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Notary Pub is State ofFbrida
COmmlS510r1 NO.y RRaUla
rhrt910n FF 191201
Commission No.
Not gg¢yc State of Florida
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02/272019
My Commission FF 191201
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17