HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/11/2018 Permit Number:
NAMES RECEIVED
Bull
irgP r it Applicati n JAN 16 2018
Planning and Development Services
Building and Code Regulation Division ST. Lude Cobf1ty, P4rMIVIn9
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: Lot 5, Yates Rd, Fort Pierce, FL 34981
Legal Description: O'BRIEN SUBDIVISION (PB 68-35)- LOT 5 (1.18 AC)
Property Tax ID #: 2419-802-0005-000-9 Lot No.5
Site Plan Name: O'Brien Residence Block No.
Project Name: O'Brien Residence
Setbacks Front Back: Right Side: Left Side:
'DETAILED• DESCRIPTIQN:OF WORK
Install one 250 gallon underground LP gas tank and gas lines to appliances.
CONSTRUCTION INFORMATION
Add orme under
itiona workto El
F]HVAC Gas Tank
this permit t c ec
FV Gas Piping
a apply:
Shutters
❑ Windows/Doors
0 Electric 0 Plumbing
R Sprinklers
_
Generator
Roof Roof pitch
Total Sq. Ft of Construction:
5 . Ft. of First Floor:
Cost of Construction: $ 4,819.00
Utilities: Sewer ElSeptic
Building Height:
01NNER/LESSEE:°.. `;
CONTRACTOR: .
Name Clyde O'Brien
Name: Gamaliel Portales
Address: 5065 NW Edgarton Ter
Company: FERRELLGAS
City: Port Saint Lucie State: FL
Address: 3232 SE DIXIE HWY
Zip Code: 34983 Fax:
City: STUART State: FL
Phone No.772-201-4173
Zip Code: 34997 Fax: 772-287-3456
E-Mail: laurieobrien@bellsouth.net
Phone No. 772-287-4330
Fill in fee simple Title Holder on next page (if different
E-Mail: mvoigtsberger@ferrellgas.com
State or County License: 01237
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIONLIEU LAW IM
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: i
Address:
City:
Zip: Phone:
D ATION:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
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.
0
Signature of Owner/Lessee/Contractor as Agent for Owner
OLD-2M440 S
Signature of ontractor/License Holder
STATE OF FLORI�A STATE OF FLORID
COUNTY OF MA I COUNTY OF
The forgping instrume t was acknowledged before me
this day of S,L 206 �by
b-& awft 0,89101111
(Name of person acknowledging)
(SigkJl' A A \Jh4
n"ture of Notary Pub li State of lorida )
Personally Known OR Produced Identification
Type of Identification ProducedbL
Commission No. W D'1'751 . (Seal)
Revised 07/ 15/2014 MY COMMISSION # GG 091751
"�• 'v EXPIRES: April 9, 2021
The forgoing instrument was acknowledged before me
this I I1 "day of TMIL '2y , 20 L$__ by
AIL9--1 NOMA
(Name of person acknowledging)
4 &A"
P C
*1gn ure of Notary Public- Sta& of Florida
Personally Known OR Produced Identification
Type of Identification Produced
Commission No. 66 Dq 1751
MELISSA S. VOIGTSBERGER
EXPIRES: ApM 9. 2021
Bonded Thru Notary Pubic tinderrRRera
REVIEWS
FRONT
COUNTER
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
ZONING
REVIEW
SUPERVISOR
REVIEW
DATE
COMPLETE
INITIALS