HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: ' t ou • V
Building Permit Application JUN 2 r� 2011
Planning and Development Services PERMiTTfNG
Building and Code Regulation Division St
Lucie County, PC
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Gas tank. r
Address:
Legal Description: 1�Rour
nn
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Install 5Q�)
rmea unaer
11HVAC Ln
Gas Tank
11 Electric _ Plumbing
Total Sq. Ft of Construction: rn
Cost of Construction: $ 00,
— cnecK a
Gas Piping Li Q Windows/Doors
Sprinklers E]Generator 1:1 Roof Roof pitch
S of First Floor:
11Ft
_
Utilities :Sewer Septic
Building Height:
OWNER/LES5`EE t
,.,: _ _.. .w... .. a..... a. �_.. ....'., .r.
u
C®NTRA`CTO"R�
.MIN.. ..
Name I tn�1 I
Name: Robert Binkowski
Company: Energized Gas
Addres '�� 'r
Address: 4252 Bandy Blvd
City: State:
Zip Code: ax:
City: Fort Pierce State: FL
Phone No.
Zip Code: 34981 Fax:
Phone No. 7728773440
E-Mail: Antonella@Energizedgenerators.com
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: 34747
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CQNSTRUCTION LIEN LAUV I°N;FOR`MATION;
..fit `. th"i§^%9y
r
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
_ Not Applicable
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
commenciu work or recording your Notice of Commencement. 1-,
ctor as Agent for Owner I Signature bf Contra for/LicensbNolder
STATE OF FLORIBQ ` ^ STATE OF FLORID
COUNTY OFF- V�,LDo j,-� COUNTY OF ULCA`Q.
The f rgoing instrument was acknowledged before me
this day of � A �Q 20 Q_by
(Name (:t person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known. OR Produced Identification
Type of Identification PLW Ic Y� o
Commission No
Revised 07/15/2014
The forgoing instrument was acknowledged before me
this Ai day of 20 by
hc(X - �v)\Lax�� 11
(Name of person acknowledging)
D lr\ J4),A � 0— () . - 46buj&
(Signature of Notary Public- State of Flori a )
Personally Known OR Produced Identification
Type of Identification Produced
Vow Notary bli fate of Florida
J � " Commission No.
Antoni ula ,tar PO Notary Public State of Florida
My Commission FF 191201
21„-.,o� Fvnirra n9r»i»rn o 1 Antonia M Paula
Explres 02127/2019
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