HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr
ALL
i and Development Services
and Code Regulation Division
ginia Avenue, Fort Pierce FL 34982
(772) 462-1553 Fax: (772) 462-1578 Commercial
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: I so.1 • 0101—
SCANNED
BY
Wit. LU.d0 00
Building Permit Application permitting Departm@nt
Lure County
Residential
RECEIVED
If R 1,7018
PER�VIIT APPLICATION FOR: Gas tank
PROPOSED IMPROVEMENT LOCATION:
Site
1720 Cody Ln
cription: Country Living Estates S/D Blk Alot 8 (172 AC) (OR 936-1090)
y Tax ID #: 2305-500-0008-000-3
n Name:
Name: Stuart
ks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
generator to existing gas line
Lot No.
Block No. _
CONSTRUCTION INFORMATION:
itiona workto e e orme under this permit— check a apply:
,IC�HVACZ Gas Tank ❑Gas Piping Ll _ Shutters Q Windows/Doors
10 Electric El Plumbing Sprinklers E] Generator g Roof Roof pitch
Sq. Ft of Construction: _
of Construction: $ 495.00
S Ft. of First Floor: _
Utilities:o Sewer F—] Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
fI11 me Harry Stuart
Name: Blake Cowdell
q:dress:1720 Cody Ln
Company: Energized Gas
City: Fort Pierce State:FL
Address: 4252 Bandy Blvd
Zip Code: 34945 Fax:
City: Fort Pierce State: FL
Phone No.772-332-2736
Zip Code: 34945 Fax: 772-318-6672
Phone No. 772-466-1095
(E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail: EnergizedGenerators@gmail.com
rom the Owner listed above)
State or County License: FL34747
value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUP�pLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESI
NER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable.
Na m:
Hang Stuart
Name' Blake Cowdell
Address-
City:IFortPierce
1720Gdy Ln
Address: 1720 Cody Ln
City: Fort Pierce State:
State:
Zip: 11
Phone
Zip: Phone:
FEE tIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Add ess:a252SandyBlvd
Name:
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. Lude County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
whichl 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 ac I11rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fgllllowing building permit applications are exempt from undergoing a full concurrency review: room additions,
accesii ory 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
imp' vements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befd�e the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
Itz"
_�_f - (A et J dW
Sig ature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Hof er
S 'J TE OF FLORIDA
STATE OF FLORIDA
C61 LINTY OF S, . L vei a
COUNTY OF �� • Lve.i e
Thl for oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
th s day of ?u �Y , 20A by
this � 7 day of u I x • 20_A by
1� '910t t . Cowdell
glakc. Cowde l l
Name of person making statement
I
Name of person making statement
P sonally Known _�_ OR Produced Identification
Personally Known_ OR Produced Identification
T e of Identification
Type of Identification
Pr duced
Produced
( 1gnature of Notary Public- State of Florida
(Signature of Notary Public- State of Florida )
•" V " NICHOLE AP T
C mmissio ,f.1jiFiLN" TEE
, .F, ,
Commissio hE APQW
:•: SION # 1 031
•: M
+
''e MY COMMISSION # FF963031
I+ EXPIRES May 04, 2020
'• n� •'
.• EXPIRES May 04, 2020
M07)308.0'53
I 40ta 8mice.com
VEGETATION
SEA TURTLE
�2EVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
It1ECEIVED
DATE
OMPLETED
8/2/17