HomeMy WebLinkAboutBuilding Permit Application 3-20-18ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/14/2018 Permit Number: 1708-0453
RECEIVED
Building Permit Applicati n
MAR 2 0 2018
Planning and Development Services ST. Lucie County, Permitting
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: 1720 S Brocksmith Rd, Fort Pierce, FL 34945
Legal Description: HAYS SUBDIVISION (PB 71-12) LOT 2 (11.105 AC - 483,734 SF) (OR 3892-858)
Property Tax ID #: 2317-500-0003-000-5
Site Plan Name:
Project Name: HAYS RESIDENCE
Setbacks Front 10 Back: 10
DETAILED DESCRIPTION OF WORK:
Right Side: 10 Left Side: 10
Lot No. 2
Block No.
IInstall one 500 gallon underground LP gas tank and line to appliances in accordance with NFPA 54 &
58.
CONSTRUCTION INFORMATION:
Additional work to be De orme under this permit — check
F]HVAC U Gas Tank Gas Piping
a
apply:
Shutters
Q Windows/Doors
11 Electric 0 Plumbing
Sprinklers
_
Generator
E] Roof Roof pitch
Total Sq. Ft of Construction:
SgFtJ. of First Floor:
Cost of Construction: $ 5019.63
Utilities: L
Sewer
F-]
Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Peter B Hays Jr
Name: GAMALIEL PORTALES
Address:1520 S Brocksmith Rd
Company: FERRELLGAS LP
City: FORT PIERCE State: FL
Address: 3232 SE DIXIE HWY
Zip Code: 34945-4403 Fax:
City: STUART State: FL
Phone No. 772-519-0558
Zip Code: 34997 Fax: 772-287-3456
E-Mail: coleconstruction@hotmail.com
Phone No. 772-287-43630 x 22577
Fill in fee simple Title Holder on next page (if different
E-Mail: mvoigtsberger@ferrellgas.com
from the Owner listed above)
State or County License: 30558
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
,SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
RECEIVED.
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_W,4R.Jpgl1F9We
Name:
Name:
Address:
Address:
ST !-ucie County, PPr_ mmv...' �
City:
State:
City:
-
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 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
commencing work or recording vour Notice of Commencement.
Signature Contract Holder
Signature of Owner/ Lessee/Contractor Agent for Owner
as
of r/License
STATE OF ORIDA
STATE OF FLORIDA
COUNTYOFINit�'fC�W
COUNTY Mm I I
The fo�rgpping instrument was acknowledged before me
this �S'"t9ay of M,i T , 20 LF by
The for ping instrument was acknowledged efore me
this ANay of NlAZ2GL-F , 20 by
fgogot
GiAlq"1 01, Po i27X1-t,�S
Name of per on making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
lAeA
St
(Sign ture of Notary Public- 5 ate of Flori a)
(Sign ture of Notary Public- )
Commission No. 4eg OBI f %S"1
Commission No. 44 Pq 1 ill (Seal
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DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17