HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APP 'ICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a. SCANNED Permit Number:
BY
Slt. uop CGS* RECEIVED
-Ilf Building Permit Application AUG 0 2018
Planning and Development Services
Buildin and Code Regulation Division I ST. Lucie County, Permitting
2300 V gmra Avenue, Fort Pierce FL 34982
Phone,;) (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERM,�T APPLICATION FOR: Gas tank '-
PROPOSED IMPROVEMENT LOCATION:
Addres �: 2001 NW Royal Fern Ct
Legal D,elscription: Harbour Ridge -Plat 6- Royal Fernvillage Unit 18
Propetfy Tax ID #: 4425-605-0032-000-7
Site PI n Name:
Project Name: Miller
Setbal', ks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
for
Lot No.
Block No.
Left Side:
(2) existing propane tanks and Install 500 gallon LP tank to generator and run a new gas line
CO STRUCTION INFORMATION:
ona wor to e e orme under this permit— check
HVAC Gas Tank ❑Gas Piping
Adcl RElectric
a
apply:
_ Shutters
Q Windows/Doors
0 Plumbing
Tot dl S, Ft of Construction:
Cos lof Construction: $ 5395.00
tl
❑Sprinklers Generator
S . Ft. of First Floor:
UtilitiestSewer 0Septic
Roof Roof pitch
Building Height:
0 NER/LESSEE:
CONTRACTOR:
Na a Thomas & Virginia Miller
Name: Blake Cowdell
Company: Energized Gas
Ad ress:614 S Federal Hwy
Ci ! : Fort Lauderdale State: FL
Zi Code: 33301 Fax:
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Ph' ne No.561-699-5030
Zip Code: 34981 Fax: 772-318-6672
E ail:
Phone No. 772-466-1095
E-Mail: EnergizedGenerators@gmail.com
Fil in fee simple Title Holder on next page ( if different
fr m the Owner listed above)
State or County License: FL34747
II rlue
If of construction is $2500 or more, a RECORDED Notice of Commencement is required. II
VI. -
SUPP(EMENTAL
CONSTRUCTION LIEN LAW INFORMATION:
DESIG
Name
Add re
City: F'�
Zip:
ER/ENGINEER: _ Not Applicable
Thomas Virginia Miller
MORTGAGE COMPANY: _ Not Applicable
Name: Blake Cowdell
Address: 614 S Federal Hwy
City: Fort Pierce State:
Zip: Phone:
� S:2001 Nw Royal Fern Ct
Laudsrdale State:
I Phone
V
FEE SI
Name'
Addre'
City:
Zip:
PLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
s:4252BandyBlvd
Phone:
Zip: Phone:
OWNEJ,eration
CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certifat no work or installation has commenced prior to the issuance of a permit.
St. Luciounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which iconflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structuPlease consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consi of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in actornce with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The folling building permit applications are exempt from undergoing a full concurrency review: room additions,
accessoIstructures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARN'�NG TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impro ements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before0e first inspection. If you intend to obtain financing, consult with lender or an attorney before
comm ncing work or recording vour Notice of Commencement.
of Owner/
as Agent for Owner
Contractor/License
STATE OF FLORIDA G , )) /� • DD STATE OF FLO
COU TY OF l %1 C COUNTY OF A Ll,a6 ,
The oing instr e t as acknowledged before
me
The forgoing instrume was acknowledged before
me,
this ay of 20 by
this ay of 201 by
oilC'
Name of p s making statement
Perso Known OR Produced Identifica
°;o� , ,cm:�
Name of per on making statement
Personally Known OR Produced Identifica
ally
n""""
n
Type f Identification
g n
Type of Identification
g r
P od ced
a n'
Produced
03 —cn
co
<3o•oD
Z3o'�r�
__•� W
m r
�6i CX
Ny "
Ny
N �
D
(Sigtis�
re of Notary Public- State of Florida)
o °_ o zh
(Signat a of Notary Public- State of Florida)
N rn d
N X N Cn
N.0 W •G =
Cornion
No. (Seal)
� m
Commission No. (Seal)
o m
N
y00
�
14
A
RENEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATA
REC - IVED
DAT
COM
PLETED
Rev. 8Y2/17