HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
Date: Permit Number:
Building Permit Application RECENED
Planning and Development Services
Building and Code Regulation Division JUN 2 1 20V
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 46271553 Fax (772) 462-1578 Commercial ResidentizrVXTTING
r-a i „r,io t';nun'-FC
PERMIT APPLICATION FOR: Gas tank
El
777-777
OR' OPOSED'IIVIPR'OVEIVIENTL.00ATIONa;
Address:
Legal Des
Property Tax ID #: "bl-\ b)
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
Install 500 gallon propane tank with Line to generator'
Left Side:
Lot No._
Block No.
Additional work to be ej rtormed under this permit— check all apply:
1]HVAC Gas Tank ❑✓ Gas Piping _ Shutters ❑ Windows/Doors
11 Electric 0 Plumbing Sprinklers F Generator F-1 Roof Roof pitch
Total.Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 3 I : Utilities:O Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR ;
�. A
Name u N-wO
Name:
Add res!;� QLIr i
Company: Energized gas
City: 'e State:
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
�1
Zip Code: 75NX( i� I .. Fax:
Phone No.
Zip Code: 34981 Fax:
E-Mail:
Phone No: 7728773440
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.
SUPPLEMENTAL CO
DESIGNER/ENGINEER:
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
�aV I1G71V GIL"IY K/'1
Not Applicab
State
Not Applicable
IRMATION
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
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 oyr cording your Notice of Commencement.
re
STATE OF FLOI,t e L� COUNTY OF
as Agent for Owner
The f rgoing instrument was acknowledged before me
this day of `u A � 20 aby
Personally Known OR Produced Identification
Type of Identificatio Produced
Y
s
Signature of Contractor/License Holder
STATE OF FLORIDA I' 6 ^
COUNTY OF l - A
The forgoing instrument was acknowledged before me
this � day of , _AN'Q 20 by
(Name of person acknowledging)
(Signature of Notary Public- State of Flori )
Personally Known l( LOR Produced Identification
Type of Identification
Notary
Commission No. V&B4tate of Florida Commission No.
,4+`� ou �; Antonia M Paula 191201
ommissiatr FF
Expires 0
Revised 07/15/201
2 Notar�ubl' State of Florida
Anto aula
X°�My Commission FF 191201
.," Expires o2/27/2019 1
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS