HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07/18/18 Permit Number:
SCANNED
BY
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P:ROPOS:ED IIVIPROVEIVIENT LQCATION ' <=
Address: 13329 NW MAPLE WOOD ROAD
Legal Description: HARBOUR RIDGE -PLAT 13- BUTTONBUSH VILLAGE UNIT 33 (OR 928-2043 THRU 2045)
Property Tax ID #: 4426-815-0040-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Taddei
Setbacks Front 10 Back: to Right Side: to Left Side: _
DETAILED DESCRfPTION:OF WORK.
INSTALL 500 GALLON LP GAS TANK AND GAS LINES TO GENERATOR
CONSTRUCTION [WORMATfON
Itiona wor to jeee orme un ert is pe rm it — ch ec all apply.
Window
OHVAC L_J Gas Tank [7Gas Piping _ Shutters
Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch .
Total Sq. Ft of Construction:
Cost of Construction: $ 3q 1LA. 'SS
S�Ftj of First Floor: _
Utilities: l _I Sewer Septic
Building Height:
OWNER/LESSEE = r°
;CONTRACTOR'
Name Vincent J Tadde & Lynne M Taddei
Name: GAMALIEL PORTALES
Address: 13329 NW Maplewood Rd
Company: FERRELLGAS
City: Palm City State: FL
Address: 3232 SE DIXIE HWY
Zip Code: 34990 Fax:
City: STUART State: FL
Phone No.
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@ferreligas.com
from the Owner listed above)
State or County License: 01237
If v0 1n of . tea. a:., r ,r..., _
- -----------•-•• •- r---- �-• .... .., a...wv..a.w •VWL1b0 vI %-villititsi ument IS requirea.
DESIGNER/ENGINEER: _ Not Applicable
Name: THOMAS COLLINS
Ad d ress: 9519 LAUREL WOOD CT. FORT PIERCE. FL 34951
City: FORTPIERCE State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: —
Ad d ress: 3232 1E DIXIE HWy
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
N a me: LAMA PORTALES
Address: 9519 LAURELWOOD CT.
City: STUART State:
Zip: .Phone: —
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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
commencing work or recording your Notice of Commencement.
Signature of
as Agent for Owner
STATE OF FLO
COUNTY OF_ ; li N17 ,C_,
The for oIng instrume�n w s acknowledge - efore me
this day of 'k_? �� 20 -Aby
Name of perso al statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of
Commission No. *• MY COJr@RJpN#GG165462
a o: EXPIR S: December 5, 2021
11 rG'` "'rFOF F °P Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
Signature of ContracGr/License Holder
STATE OF FLOD R ,Q
COUNTY OF
_`��
The fgrgdoing instr•.um nt as acknowled d before me
this 9 `e day off``1 t) (.� 20 i by
Name of per p making statement
Personally Known V_ OR Produced Identification
Type of Identification
Produced
(Signature of>6ta' bli bls a to o
PP
20 LY GALEN+
Commission No_ *. MYC�M #GG 165462
,, !1 �, FSF�a.; EXPIRE :ember5, 2021
Bonded Thru Notary Pubrrc Underwriters r'I
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW