HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED — ® 0 D - )
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BY
3t. Lude COMO/ AUG 0 7 2'-01$
Building Permit Application
Permitting Departm nt
nning and D velopmentServices
'� St. Lucie County,
(ding and Code Regulation Division • j/
)0 Virginia��'enue, Fort Pierce FL 34982
ane: (772)62-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APII LICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED I MPROVEMENT LOCATION:
Address: 3304I�aracal DR
RR/ERPOINTE ATTNE SANOS (PB 3312) THAT PART OF LOT 1 MPDAP. BEG NW OOR OF LOT 1 RUN N 6S M 18 E ALO N LI 116.09 FT.TH S 600145 W 116.04 FTTO W LI OF LOT 1,TH N 284421 W ALG W LI I FTTO POB ANDALL LOT 2 (0]
i
rerty Tax l #s
1426-503-0007-000-4
�
Plan Nam
act Name:
II '
Front 10 Back: 10 Right Side: 10 LeftSide: 10
DETAILED DESCRIPTION OF WORK:
Lot No.1, 2
Block No.
I I STALLATIION OF 2 - 420# 120 UG LP GAS TANKS AND LINES TO GENERATOR
n er�i'o ►�' - ter '-� l o', ��i
CONSTRUCTION INFORMATION:
I�
AdClitional w r to e e rmed under this permit — check a apply:
[]HVAC _ Gas Tank ❑� Gas Piping _ Shutters Q Windows/Doors
Electri , 0 Plumbing Sprinklers ElGenerator 11 Roof Roof pitch
tal Sq. Ft oI Construction:
Ist of Cons I uction: $ 3165.85
11
S Ft. of First Floor:
Utilities
:Sewer Septic Building Height:
'OWNER/L SSEE:
CONTRACTOR:
Name ,lanen Sigismondi AND Evgeny Platov
Name: GAMALIEL PORTALES
Address: 3344 Caracal DR
Company: FERRELLGAS
Address: 3232 SE DIXIE HWY
City: Hutchinson Island State: FL
Zip Code: 3Ij, 949 Fax:
City: STUART State: FL
Phone No. I
Zip Code: 34996 Fax: 772-287-3456
E-Mail: I
Phone No. 772-287-4330
Fill in fee sirj�pie Title Holder on next page (if different
from the Oe►ner listed above)
E-Mail: emilygalen@ferrellgas.com
State or County License: 30558
1 If value of cohstruction is $2500 or more, a RECORDED Notice of Commencement is required. 11 1 ® _-/
"
tU'PPLE11�
NTAI_ COyN5TRUCTIO'N LIEN ;LAVV INFORMATION
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.
DESIGNER/
NGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:THa!Ak f
OLLINS
Name:GAMAPORTALES
URELWOOD CT. FORT PIERCE, FL Sass,
Address' 9519
Address: 9518 LAURELWOOD CT.
City: FORT PIER
City: STUART
State:
E' State:
Zip:
Phone
Zip: Phone:
FEE SIMPLE ITLE HOLDER: _ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:3232 EDIXIEHWY
Address:
Ity: 1
City:
Zip: Phone:
Zip: Phone:
VER/ CO TRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
ify that nor work or installation has commenced prior to the issuance of a permit.
Cie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
I is in cone ct with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
:ure. Pleas consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideratior11of 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.
following b ilding permit applications are exempt from undergoing a full concurrency review: room additions,
ssory struci res, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
ING To OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
emen s to your property. A Notice of Commencement must be recorded and posted on the jobsite
the fib t inspection. If you intend to obtain financing, consult with lender or an attorney before
racing �inrork or recording vour Notice of Commencement.
ignature of Owner/ Nessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF F10 A STATE OF FL ID�4 y
COUNTY O 1i ,� COUNTY OFr
The forgoing i str ent was acknowledged_before me The forgoing instr ment wa acknowlecig efore me
this day �f U 26 by this a day of (I J 20 by
ep
Nam16 of persopftaking statement Name of pers making statement
Personally KAwn OR Produced Identification Personally Known OR Produced Identification
Type of (dent ication Type of Identification
Produced Produced
(Signature Of7Jotary _!1= �1 � � (Signature of Ntary
<� ..
iq•' ` ILY GALEN
.. o.,:...:.EMILY GALEN
?
Commission
o.
:*: :* MyCOMORIJIN#GG165462
MY COM
Commission No. *' 4§9A#GG165462
EXPIRES; Decembers, 2021
•.FOF
5�� '•'FOFcCQQ' EXPIRE December 5, 2021
�; �, Bonded Thor No Lary Public Underwriters
6� Bonded ThN No WY Public Underwriters
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
TE
t
CEIVED
(DATE
COMPLETED,
tev. 8/2/17