HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .p
Date: Permit Number: /1*- o la%
RECEIVE'®
Building Permit Application AUO 2 3 2017
Planning and Development Services PEAMITTiNG
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 tank
El
PROPOSED IMPROUEM°ENT'"LOCATION.. s
Address: 8330 Hidden Pines Road Fort pierce FL
Legal Description: Lot 5 Block A Hidden Pines Estates
Property Tax ID #: 232370100050005 Lot No.5
Site Plan Name: Block No. A
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF"WORK:
Install 500 gallon underground Propane tank, with 5 drops
CONSTRUCTION INFORMATIONK
Additional work to be
11HVAC
nertormed
under tnis permit— cnecK aii
❑✓ Gas Piping
apply:
Shutters
a Windows/Doors
L� J
Gas Tank
_
11
Electric
El
Plumbing
Sprinklers
0
Generator
El
Roof
Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ , ���,5
S Ft. of First Floor: _
UtilitiesSewer I Septic
Building Height:
OWNERAESSEE:
CONTRACTOR: a U
Name Mary Hempstead
Name: Robert Binkowski
Address:921 Plover Ave
Company: Energized Gas INC
City: Miami Springs State:FL
Address: 4252 Bandy Blvd
Zip Code: 33166 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.
5
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFbRMATIQN:
DESIGNER/ENGINEER: _ Not Applicable
N a1 1m e : Mary Hempstead
Address:5336 Hidden Pines Road Fort pierce FL
MORTGAGE COMPANY: _ Not Applicable
Name: Robert Binkowskl
Address: 921 Plover Ave
City: Miami Springs State:
Zip: Phone
City: Fort Pierce State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Ad d ress: 4252 Bandy Blvd
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 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
CID encing work or recordine vour Notice of Commencement. .11
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Li erise Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF-WWoe
COUNTY 0FU.1L.da
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 18 day of August 20_ by
this 18 day of August 20_ by
Robert Binkowskl
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 f Identification
Type of Identification
Pro u ed A
Produced
- a e o F o i
(Signature of Notary Pur!e�o'A-0%11
(Signature of Notary Public- State lorida I
Notary�uW State of Florida
No.Anton] 95I aula
lcState of FloridCommission
Commission No. '�' A� Paula
t� My commission FF 191201
02/272019
My commission FF 191201
02/272019
OF µ6• Expires
Expires
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17