HomeMy WebLinkAboutBuilding Permit Application 8-22-17ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/22/17 C/ Permit Number:
Building Permit Application AUG 2. 2 201?
Planning and Development Services PEr,M1171Cv"A'
Building and Code Regulation Division St. Lucie CeLM�Ly, FL
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 Lot No. 2
Site Plan Name: Block No.
Project Name: Hays Residence
Setbacks Front 10 Back: 10 Right Side: 10 Left Side: 10
DETAILED. DESCRIPTION OF WORK::'
Install 1-500 gallon underground LP gas tank and line to four appliances in accordancerW NFPA 54
and 58
CONSTRUCTION INFORMATION:
ACICUtIonal worK to e performed under this permit — c ec
11HVACZ Gas Tank 7Gas Piping
a
apply:
Shutters
Q Windows/Doors
_
11 Electric 0 Plumbing
U
Sprinklers
01 Generator
Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 5019.63
Utilities:
Sewer
F-1
Septic
Building Height:
'OWNER/LESSEE:
CONTRACTOR.
Name Peter B Hays Jr
Name: Jonathan Hurd
Address:1520 S Brocksmith RD
Company: Ferrellgas LP
City: Fort Pierce State: FL
Address: 3232 SE Dixie Hwy
City: Stuart State: FL
Zip Code: 34945-4403 Fax:
Phone No. 7721519-0558
Zip Code: 34997 Fax: 772-287-3456
E-Mail: coleconstruction@hotmail.com
Phone No. 772-287-4330
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:
If value of construction is S2500 or more, a RECORDED Notice of Commencement is required.
,.SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
_ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
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.
vv v S
Signat ry
of Owner/ see/Contractor as Agent for Owner Signaturg4of Contractor/License Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF MAk=1 N COUNTY OFA RT1 r i
The forgoing instrulnent was acknowledged before me The forgoing instrument was acknowledged before me
this day of U_,5,'F 20 (2by this W'day of AIM (.(,,!�T 20 1 -1 by
JOt,*Ct A14 k-fb I �r� k1upA ktgz
(Name of person acknowledging) (Name of person acknowledging)
re of Notary Public -
Personally Known _ OR Produced Identification
Type of Identification Produced
Commission No.
MELISSA S. VOIGTSBERGER
Revised 07/ 15/2014�I eonded TtuoRnEomSrywba9c' �2ur,ae mites
(Signat6re of Notary Public- Stale of FloriM )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
MELISSA S. VOiGTSBERGFR
EXPIRES: Apr# 9, 2o2i
Bonded 7ft NoWy PLt& uWerreA=
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS