HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONPPLICABLE NFO /MUST BE COMPLETED FOR APPLICAIAON TO BE ACCEPTED
` / Permit Number:
SCANNED K 1111 IT I- �
Ley DAM
� . Lucie County AUG 0 7 2018
Building Permit Application .
ing and Devi lopment Services
ng and Cod Regulation Division
Virginia Avinue, Fort Pierce FL 34982
e: (772) 4 -1553 Fax: (772) 462-1578
Permitting Departme t
St. Lucie County, FL
Commercial Residential X
PER11
MIT APPL
CATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED'! M
PROVEMENTLOCATIQN.
Address: 1491 NVIV SEETBAY CIRCLE
Legal Description HARBOUR RIDGE -PLAT 9- WEST HAMMOCK VILLAGE UNIT 2 (OR 4103-871)
Property Tax ID # 4426-804-0035-000-2 Lot No.
Site Plan Name: Block No.
Project Name: EllanDThompson
Set acks Fronl 10 Back: 10 Right Side: 10 Left Side: 10
[7.D[TAlltUQIE, CRIPTION OF WORK:
Instillation of 1 Q00 Gallon UG LP tank and run lines to generator water heater,gas cook top BBQ and
fire lace
'CONSTRUCTI
.N INFORMATION
Additional
®HVAC
work
e ne orme under tis p mit-checka app y:
a
Lr J Gas Tank LNAGas Piping _ Shutters Windows/Doors
11
Electric
0 Plumbing E]Sprinklers ElGenerator 1:1 Roof Roof pitch
Tota
Sq. Ft of Co
truction: Sq. Ft. of First Floor:
Cost
of Construct
n: $'MS O Utilities: 11 Sewer O Septic Building Height:
OV1jNER/LESS'
E:
CONTRACTOR:
Na rn
Address:1589
City:
Zip
Pho
E-Mlail:
Fill li
frorr
a Ellen D Tho
pson
Name:
Company: FERRELLGAS
Address:.3232 SE DIXIE HWY
N
Palm City
Sweetbay Cir
State: FL
Fax:
ode: 34990
a No.
i fee simple
the Owner
City: STUART State: FL
Zip Code: 34997 Fax: 772-287-3456
Phone No. 772-287-4330
E-Mail: emilygalen@ferrellgas.com
State or County Licenser
itle:Holder on next page (if different
sted above)
It vale of construllion is $2500 or more, a. RECORDED Notice of Commencement is required.
5;U
PL' ME
(i AL�C� ISTRUC ""' '4 LI'�N LA►W !N'FO'RIVIATIO�N'
DESIGNER/E
N
Address
CI#y:
Zi
m e: THOnwS CQINS
• 9519 LA4I
FORT PIERCE
INEER: Not Applicable
MORTGAGE COMPANY:+ Not Applicable
Name.• . GAMA PORTALES
Address: 9519 LAURELWOOD CT..
City: STUART State:
Zip: Phone:
2ELWOOD CT. FORT PIERCE, FL 34951
I State:
Phone
FEE
NJIme:
Ad
Ci
SIMPLE Tl
d ress: 3232 SE
y:
LE HOLDER: _ Not'Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
'IXIEHVVY
Phone:
Zip: Phone:
Zip:
U%RINtK/ GQNT�rk
ACTOR AFFIDVIT: Application is hereby made to obtain a permit, to do the work and installation as indicated..
I cel-tify that now or installation has commenced prior to the issuance of a permit.
St. L icie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict ith any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please c nsult with your Home Owners Association and review your deed for any restrictions which may apply.
In c nsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in a Icordance wO the approved plans, the Florida Building Codes and St. Lucie County Amendments.
TheTollowing buildling permit applications are exempt from undergoing a full concurrency review: room additions,
accei sory structuriL, 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
impIrovements'lo your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first nspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owr ler7 Lessee/Contractor as Agent for Owner Signature of Contrar/License Holder
STATE OF FLO MOA STATE OF FLORIDA @� a
COUNTY OF COUNTY OF NiLI l V'i
The f oing ins
thi day off
nt was acknowledge before me
20
The foc�r oing instr t was acknowled a before me
day
by
this —�1-- of 20 by
Name o
perso making statement
Name of pers n making statement
Pe sonally Know
OR Produced Identification
Personally Known OR Produced Identification
Type of Identific
tion
Type of Identification
Pr duced
Produced
(Signature
a (Signature�6f g)ta u
_ °o<'$ "`.; EMILY GALEN �/ =°` " :. EMILY GgLEN
Commission
No.
`+: ;+ MYCOMMI�®�#GG.165462 Commission No. :+= MYCOMMI
�i.�ii�GG165462
EXPIRES: December 5, 2021 lu(SqWL; �oF oP`., IRES: December 5, 2021
F i;,.. Bonded Thru Notary Public Undenwriiers Bonded Thru No tary No Undenyriters
FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
REVIEWS
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17