HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONe
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 'Q
Date: - �• �$ 1 "g• SCAN & By D Permit Nu
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Building Permit Application SUN 18 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division g p
2300 Virginia Avenue, Fort Pierce FL 34982 , St. LUCIe CO �/I FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Gas tank =1
PROPOSED IMPROVEMENT LOCATION:
Address: 9382 Scarborough Ct
Legal Description: Pods 12 & 13 Pud 1 at The Reserve
Property Tax ID #: 3322-507-0014-000-5
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Run and connect new gas line from existing tank and final connect
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work to be nertormedunder this permit— check T
app y:
E1HVAC L� I Gas Tank Gas Piping_ Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 995.00
S Ft. of First Floor: _
UtilitiestSewer OSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameDaniel Damiano
Name: Blake Cowdell
Address: 9382 Scarborough Ct
Company: Energized Gas
City: Port Saint Lucie State: FL
Zip Code: 34986 Fax:
Phone No.
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: EnergizedGenerators@gmail.com
State or County License: FL34747 .10
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
r
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Daniel Damiano
MORTGAGE COMPANY: _ Not Applicable
N a me: Blake Cowdell
Address: 9382 scarborough Ct
Address: 9382 Scarborough Ct
City: Port Saint Lucle State:
Zip: Phone
City: FortPierce State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:4252 Bandy Blvd
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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
commencinE worK or recoraina vour ivoLice oT t-ommencemeni.
a da
ntractor as Agent for Owner Signature of Conti actor/License Holder
STATE OF FLORIDA _ STATE OF FLORIDA
COUNTY OF i�1. W C' ie COUNTY OF S4, buc l,e
The forgoing instrument was acknowledged before me
this day of I flP, 20A by
Ice, LWdell
Name of pe son making statement
Personally Known OR Produced Identification
Type of Identification
Produced
- 1-1Q,& 5
(Signature of Notary Public- State
FOC713-98-0*53
NICHOLE AI
Commission No. f Fq303(COMMISSION
-e) S/4lZvEXPIRES May rloridallo:a�ySory
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 8/2/17
The forgoing instrument was acknowledged before me
this _ it day of _ �J' J vu_ , 20A by
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public -State of Florida J
1,2020
986I i on No. -►. NICEI®LE(MQ�itdTE
MY COMMISSION# FF963031
EXPIRES May 04, 2020
PLANS I VEGETATION I SEA TURTLE I MANGROVE
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