HomeMy WebLinkAboutBUILDING PERMIT APPLICATION__.4
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/16/18
�f to BY
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Building Per
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Corn
PERMIT APPLICATION FOR: Gas tank
Permit Number:
RECEIVED
it Application MAR 91 02
ST. Lucie County, Permitting
!rcial Residential X
PROPOSED IMPROVEMENT LOCATION: i
Address: 2830 BROCKSMITH RD I
Legal Description: SUBDIVISION OF MC NURLEN FARMS
4 LOT 12-LESS W 193 FT- (8.02 AC) (OR 1152-1659)
Property Tax ID #: 2320-501-0064-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Hamrick Guest house I
Setbacks Front 10 Back: 10 Right Side: 10 Left Side: 10
I
DETAILED DESCRIPTION OF WORK:
Leased 120 under ground LP gas tank and gas line to appliances
I
CONSTRUCTION. INFORMATION: ;t
Additional work to be nertormed under this permit —check all apply:
i
11HVAC Gas Tank ZGas Piping Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 11,Generator 1-1 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,118.15
S Ft. of First Floor: _
Utilities: Sewer E]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Carissa H Hamrick
Name: GAMALIEL PORTALES
Company: FERRELLGAS LP
Address: .3232 SE DIXIE HWY
Address:2830 S Brocksmith.RD'
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
City: STUART State: FL
Phone No. 772-201-4939
Zip Code: '34997 Fax: 772-287-3456
E-Mail: cynthiap7129@gmail.com
Phone No., 772-287-4330 X 22577
E-Mail: mvoigtsberger@ferrellgas.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: 30558
it vague or construction is :>Asuu or more, a Krwrcut) Notice of commencement is required.
I.S,UPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
INEER: _ Not Applica
Name:
Address:
City: State
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:_
Zip:
I certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
Not Applicable
State:
Not Applicable
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 hereb;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 your Notice of Commencement.
re of
as Agent for Owner
STATE OF FLORIDA COUNTY OF IR,)d�Yi1
The forgoing instru ent was acknowledged before me
this � day of l IM 20 i`9 by
STATE OF FLORID
COUNTY OF RWJb,)
The 9,ayof..MkQ9
ng instrument was acknowledged before me
this , 20 LL_ by
(Name of person acknowledging) (Name of person acknowledging)
w U-
(Signatu e f Frotary Public- State of Florida) (Sign ture of Notary Public- At- of Flori )
Personally Known OR Produced Identification X Personally Known OR Produced Identification
Type of Identification Produced F L 'p-nNXV S CD,Y1 Type of Identificatio Produced
Commission No. C-I&1(_0sLAL9a Commission No.6A0gI ZS1 (Sea
3r?�.,, EMILYGALEN MEUSSAS.VOlG1SBE09A751
MU
EXPIRES: December 5, 2021 :fit' MY CO019,1
Revised 07/ 15/2 ' q i; °'. Bww-mn, Notary► uw and em N r oS+an� `una
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