HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services ,-•- �;.;;
Building and Code Regulation Division pEF�i�lcounty, r�
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Gas tank E
PROPOSED 3UPROVEIUIEEN,T`L'OC�ATI0'_bnil
mow'
Address: 9608 Knollwood Lane Fort Pierce FL 34951
Legal Description: Monte Carlo Country Club unit three lot 46
Property Tax ID #: 1327-107-016-000-4 Lot No.46
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION' F UUORK �`"���sa
Install 500 Gallon Propane tank underground with line to generator
CONSTRUCT[ ON INFORMATIQN' j.01
MgiI"i�krd�i•
Additional work to be performed un
er t is permit — check all
app y:
�HVAC
LJ
Gas Tank
❑Gas Piping
_
Shutters
a
Windows/Doors
0
Electric
Plumbing
Sprinklers
Generator
g
Roof
Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 2195.00
S Ft. of First Floor: _
Utilities:CnSewer Septic
Building Height:
OWNER/LESSE°E ;'!
CONTRACTOR
ri dH h, A Wn lrif
Name Terry Gamer
Name: Robert Binkowski
Addreso,.9608 Knollwood Lane
Company: Energized Gas
4252 Band Blvd
Address: y
`' Font Pierce.
City:' :,.' State: _
49�
Zip`�C'de', ,. Fax:
City: Fort PierceState-FL
Plpri,e; No:' 3; ,:. ,
Zip Code: 34981 Fax:
E'M il: :,^ _,
Phone No. 7728773440
Filt`iri fee; itnple Title Holder on next page ( if different
Ener ized Antonella enerators.com
E-Mail: @ g g
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.
, INFIJRIVIAMR
SUPPLEMENTAL CONSTRUCTION N LAW
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
Zip: Phone:
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.
as Agent for Owner I Signature
STATE OF FLORIDA STATE �,I�� ��� COUNTY OF OF 3r, LLD
COUNTY OF 1Ail. t�t�
The forgoing inst ent wa acknowledged efore me
this fJ day of 20 by
ILIQU-' L &)Iy5%i
(Name of erson acknowledging)
(Signature of Notary Public- State of Florida'
)
Personally Known OR Produced Identification
Type of Identification Produced
The forgoing instrument was acknowledged before me
this ,c5— day of K1� , 20 _a by
k)0*U+ S nVQS j
(Name of person acknowledging)
(K 4ca
(Signature of Notary Public- State of Flori a )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. T 76Commission No.
ty,
Nota�lic State of Flon a
Antonia uv Doan FF 191201
ri _s o Expires 0212 , j i
Revised 07/15/2014
Notary Puhlic State of Florida
Antonia M Paula
Expires 02127/2019
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS