HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONs
ALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
`6 Permit Number: `'� d 5- C�3
Date: �` 0l3 � �,
BY
Building Permit Application RECEIVED
Planning and Development Services MAY 2 3 L9018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie County,_Pe�
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Res dent'rai—�-
PERMIT APPLICATION FOR: Gas tank
PROPOSED IMPROVEMENT LOCATION:
Address: I So l N LJ BAOMCU_6 u e-C e 3 LO/ 9
Legal Description: We hour in I!q e - Tlg:> 13 1&Apm6,,5(-+y. Ilaq G VA;
Property Tax ID#: y4AU- $15 - 6010 -666-S Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
�s l I 5oa Gam.I I on LP T ae% car,
1
CONSTRUCTION INFORMATION:
Additional work to be ne orme un er t is perm - c ec a apply:
0HVAC L =1 Gas Tank Gas Piping _Shutters ❑Windows/Doors
Electric F-1 Plumbing Sprinklers Generator F1 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. ` Ft. of First Floor:
UtilitiesSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name C-Oloe.J'+
Name:
Address: 1501 bj++_0 �kn, 4% Ci r-
`&.JQ.
Company: rN
City: Nam G1h1- State: &
ZipCode: 3q N q 0 Fax:
Phone No. _02!:I:g
E-Mail: Fir\ @ T89 DDP, Cbm
Address: 4 ;LS 2 J"V &,o
City: & r
y: ,±� C 1' +` G. t••2- State: FL
Zip Code: '3" g 1 Fax: '772-c319-(-P(972
Phone No. ?/2— (g&— /d 95
E-Mail: J& eC%, 2 ANCXI C b,. QIS�% �c rAg. Ow'!
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: FLJg7Y %
IT value or construction is >csuu or more, a KLLUMMIL) Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: I Not Applicable
BONDING COMPANY: Not Applicable
Name: I
Name:
Address:
Address: I
City:
City:
Zip: Phone:
Zip: Phone: I
OWNER/ CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 your Notice of Commencement.
a � I -(-.- A)l I
All,, I
Signature of Owner/ Lessee Contractor as Agbnt for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA I;
COUNTY OF L�L�Q,
STATE OF FLORIDA CS'
COUNTY OF
cJ>—.
The for oing instrument was acknowledged before me
by
The for oing instrument was acknowledged before me
this ga day aO-V 26 I by
this day of M Q j 20]t
of
Name of per on making statement I
Name of person making statement
Personally Known OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification I
Type of Identification
Produced I
I
Produced
*_�1gLUL axaktz
(Signature o ,IypJWY Pub CIAWf F dNh 'i
(Signature of
ktary P6blic- State of Florida
=•�" •': MY COMMISSION # RJ03T
Commissi
Commission N
v ' N9 'HOLOE A TE
:=
VP&3031
May 04, 2 12
(407( 398-0'53 nmidallotarysorvmxom
-GOMMISSION
'•, ,gd EXPIRES May 04, 2020
(407)398.0'53 FloridallotarySerAw.com
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17