HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONMALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
,i Date: SCANNED Permit Number:
BY
St. Lucie County
. ti Building Permit Application �°�� ✓G
Planning and Development Services
Building and Code Regulation Division �11/0 od
I2300 Virginia Avenue, Fort Pierce FL 34982 CO.S t'
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Gas tank
PROPOSED] MPROVEM ENT LOCATION:
Address: 9403 MEADOWOOD DR
Legal Description: MONTE CARLO COUNTRY CLUB -UNIT ONE- LOT 181 (OR 3930-403)
Property Tax ID #: 1327-801-0070-000-7 Lot No.181
Site Plan Name: Block No.
Project Name: COMPLETE/WELCH
Setbacks Front-1 0 Back: 10 Right Side: 10- Left Side: 10
DETAILED. DESCRIPTION OF WORK
INSTALL 500 GALLON LP GAS TANK AND LINES TO. GENERATOR
CONSTRUCTION INFORMATION 3
itiona wor to e e orme under this permit —check all apply:
gHVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: S, 3700.85 Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE ,,,.
CONTRACTOR:
Name Deborah A Welch
Name: GAMALIEL PORTALES
Address: 9403 Meadowood Dr
Company: FERRELLGAS
City: Fort Pierce State: FL
Address: 3232 SE DIXIE HWY
Zip Code: 34951 Fax:
City: STUART State: FL
Phone No.678-591-4922
Zip Code: 34997 Fax: 772-287-3456
E-Mail:
Phone No. 772-287-4330
Fill in fee simple Title Holder on next page ( if different
E-Mail: EMILYGALEN@FERRELLGAS.COM
from the Owner listed above)
State or County License: 30558
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required.
ALL APPLICABLE INFO M"'UST' O COMOUTED FOR APPLICATION TO B ACCEPTED"
Date:Permit Number•
'1 %a ', 4 ,Cj ddHi� eY,fi�+ ri y,• 'I ,
Building "P�rrrit Application
t 1 Planning ontl Development Services
BulldTng and Code Regulgtlon DTvrsion
23,00 Vlrglgla Avenue, FQft Pferce,1 y 34982
Phone'(77,2)4621553 .Fax '(7.72)4621578,,. COt71Yn21"CiaF;__r_______ .
R esldentlal' X ':
IPERMIT APPLICATION>>FOR Gas tank
,OpOSD iMPRiDVEMEN C'� zt 1
'pRv
!
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Address
P31. MEAD0INOOD DRI
, E � ,
Legal Description.:'
ONTE CARLO COUNTRYCLUB UNIT ONE` LOTt181 (OR 393Q 403)
( 1327r8011'0070 Q00=7, Lot' No 181
Property Tax ID#• +
Wdck No
Site Plan";Name.
t Project Name COfNPLETENUELCH
Selt�acks Front�10 pack 10 Right Side 10 �t Lef# Side
'10
I.
f ,• fi! 7 q !l, tt ti
'C ETAI 'El
j D;ES.Ct�IPTIIG � ! , ? !{•, ° Ft I A i ,a t n k^ � 7 4} fir
INSTALL 500 GALLON LP'GAS TANK AND'LINS: TO GENERATOR
,
U'L
} 1 1 y
CONSTRU''I k NsINF04RMAlCN.
1
„
onavwor ,to e:- a orme up er; iszpermi —c ec a appyt "•
Windows Doors
HVA'C' Gas Tank Gas Piping _Shutters" /,
Roof �____,� Roof,pitch
Electric LJ Plumbing • Sprinklers Generator
Total Sq.��Ft ofConstructiori S Ft �'of First`Floor:
3700 85 t�hties Sewer Septic 9wlding Height I'
Cost of Construction $
U
�I
5 I i
QWN E ' lLE5SEE." ��I�Ah! f,l ,aid+aN II+ I of I x ! { "+ } r' CONTRACTOR.
91�H".� 1 s 9 1 `t3 1
Name Deborah A'V1lelch aim St
N e G�4MALIEL I?QRTALE
s
Address'9403 Meadowood,Dr ; Company
FERRElLGAS'
FL 3232 SE DIA MWY,
Clt Fort Pfercel`; State:, Address
Zip Code. 34951, Fax` City rSTUART State: FL
Phone No 678 591 4922 Zip Code 34997 Fax 772-287-3456
E,-Mail Phone No ' 772` 287-4330,
Fill in fee' imple'Title Holder on next page (if different E 10' it EMILYGALEN@FERRELLGAS:GOM
from the'Owner listed .above) State or County license: 3,0558 "
I( value of consEru'ction is $2500 or"more, a RECORDED`IVot 6 of Commencement isrequired.
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DESIGNER ENGINEER: ,. `Not;Aoiolkable 'MORTGAGE,COiVIPANY::
Not'Applicable,,'"
Name•
Marne
Address:
Address 1
City i'
State
City
..!State':,
Zip Plane
Zip P lone
`
FEE SIMPLE TITLE HQLDEIft ,'
'Not App0 "16le
'BONDING CCIMPANY:'.,
Not''Apphca'ble
Na'rne
: Name:
.
Address: i.
Address
City
c�t�y
Zip r Pfi`o'ne
Zip Phone
i
;
t., a
OWNER/`CONTAACi'OR AFFIDVIT.`Qppticatioh Is hereby made to o`ptajn a permit to do the ,work acid installation` as`.indicated..
t certify that now,ork ar installation}has commencetl prfor'to th'd'issuance`ofra permit `
St, Lucle' Countyy makes nose resentatlon;that (s ranting a.ppermitill authorize the hermit h•oitle to build,the,sub�ect's`tructure„
which is,;in,conflict;vuithtan, ,appticable1Home Ownd6 Assaciatlon riles, byNws or m,) tovenantsl at, ay restricC.oro.rohibit such ,
structure Please con`sult,th your Hpme,Owners Association antl review your dead for al?Y restrictions which may apply;' .
In consideration of the granting of this requested�permlt, I do heresy agree that I'wllljin all respects, perform the work
in accortlance with t e approved plans, the Fioritla`euildlnE Codosand St 'Lucie County "Amenments
;.
The following building pef m(t applications are exempt from. undergoing a full concurrency review, room addit(onsi%
accessory structures, swimming pools, fences, walls, signs,.screen ,rooms and accessar�i Lses to anotherhon residential .use '
WARNING TO OUVNER Ypur fa11i1re to Record a Notice of -Commencement may result'in your;paylrjg"twice:for
impravernents to yourproperty A'Notice of Cornrnencement must be recorded and posted'oh the jobsite
before the,first,inspection if,.you intend ta;obtait7'financmg, ConsUltvuith lender or an atxori�ey before;`
commer`icin work o 'r,:ecording=your Notice,of Commencement'{
v,V,.. .. ,
nature p Owner/ Lessee/Contractor as�Agent for Owner Signature of Contra or/License Holder
STATE OE FLO 1 A STATI OF FL(i t
COUN°ifYrOF��yN. COUNTY OF ' �,
The r ping mstr ment was acknoWledge befare;me,' The fpr ping instr rner t was' ackMo liedg d�for6 methis'daY of 20y ihis'day p`fA A s20 y
._ ._...
Name of;perso akingstatement Name;of pers .n making statement
Personally,Known' r ,;QR Praduced'identification NO hdlly Known QR Pr' ducod Iderttffication
Type of1dentification, Type,of Identiffeation
Produced ,Produced
Go
{Signature of t'ary Public State of Florida) (Signature otary P,u 1"r
Commission IVo. �'�" gAfai�L '�'y�e, �YGALEN
EN Commission hlo. r
* ,_ CQMMISSIatd # G016ix#62 l m * M1' Cd I # G 165462
} `f�► �s�it..R" , ,� F.XPiItES DecemDer6 2021 '! ins � ;�� Q.o` EXPIRES `DeCer r:6, 2021
' o dERP�.. ,P,FryO` Bonded7llNNotaNi?iiblklUrldaM7$e►s
VEGETATION SEA TIiRTLE Mi4NGRO.
-REVIEWS fRONT 0NING SO' '' ISOg PLANS VE
COUNTER REVIEW' REVIWREVIEW REVIEW REVIEW REVIEW
DATE :.
i RECEIVED
DATE
CQ'MPLETED.
Rev, 8/2/17