HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR
Date: 5/23/18
AIL4900_
Build
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
CATION TO BE ACCEPTED
Permit Number: on
14S
RECEIVED
init Application JUN ,05 2018
Permitting Department
St. Lucie County
mmercial Residential x
PERMIT APPLICATION FOR: Gas piping I
PROPOSED IMPROVEMENT LOCATION:
Address•. V7 S LwL(nd-
Legal Description: TREASURE COAST AIRPARK LOT 71 AND fI?I20 FT STRIP ADJ ON S MPDAF: BEG AT BE COR OF LOT 71 RUN S 89 33 44 W 375 FT, TH S 1
4 2139 W 20.70 FT, TH N 89 33 44 E 380.36 FT. TH N 00 32 21 W 2b FT TO SE COR LOT 71 AND POB (4.30 AM (OR 1884-329 : 2131-887: 2957-429: 3471-591)
Property Tax ID #: 4224-501-0071-000-6
Site Plan Name:
Project Name: NAUGLE G
Setbacks Front ) i� O Back: 3�
Side: _ I 'P U Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I I
GAS LINE INSTALLATION FROM EXI
G PROPANE TANK TO GENERATOR
CONSTRUCTION INFORMATION:
Additional work to Ieeleorme under t is perm t —check: a apply:
11HVAC LJ Gas Tank IGas Piping _ Shutters ❑ Windows/Doors
Electric El Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: I S�Ft.I of First Floor:
Cost of Construction: $ 537.00 I Utilities: Sewer []Septic Building Height:
I
OWNER/LESSEE:
CONTRACTOR:
Name DAVID NAUGLE
Name: CHEYENNE ELLISON
Company: PROPANE SERVICES INC
Address: 15367 SKYKING DRIVE
City: PORT ST LUCIE State: FL
Address: 2130 SW POMA DRIVE
Zip Code: 34987 Fax:
City: PALM CITY State: FL
Phone No.
Zip Code: 34990 Fax: 772-220-1829
E-Mail:
Phone No. 772-220-9678
Fill in fee simple Title Holder on next pagI ( if different
E-Mail: INFO@ELITEGASCO.COM
from the Owner listed above)
State or County License: 18361
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW 'INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address: I
Address:
City: State: I
City: State:
Zip:, Phone I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicab a
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: I
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is h ireby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced priorito the issuance of a permit.
St. Lucie County makes no representation that is granting 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 Associa ion and review your deed for any restrictions which may apply.
Inconsideration of the granting of this requested permit, do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Build! g 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 otice of Commencement may result in your paying twice for
improvements to your property. A Notice of Co 1 mencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obta n financing, consult with lender or an attorney before
commencing work or recording your Notice of Qommencement.
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Sign 6re�Ow see contractor as Agent for Ovyner I Sign ur tracto icen es Holder
STATE OF COUNTY FLORIDA A �V p�� I STATE OF FLORID \
llV' —1 I COUNTY OF Q�J
The forgoing instrument was acknowledged before me The f going instrument was acknowledged before me
this � day of 201h by this day of 20�L6 by
Name of pers?l making statement
Personally Known OR Produced Identificatio
Type of Identification
Prod ced
nature of No ry Public- St of Florida )
Commission No. :od`' 2:Pi
kfiWIN
ealyotary L
Lacey L
y • My Comr
Expires 1
Name of pn making statement
ers
Personally Known OR Produced Identification
Type of Identification
Produced
ignature oi< Notary Public= gbiKe of Florida )
State of F ohm Sion No. err[. a Notary
Public State
�n GG 16 732 ;� Lacey L Rizza
1221 Ex Ces 2'/17/2 2ssion G
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17