HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLI ABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
`CANNED �� •����I
Date: BY Permit Number:
Sit
Luck) Coant/
DECEIVED
Building Permit Application
Planning ,Ind Development Services AUG 0 91010
Building d Code Regulation Division
I(" Permitting Department
2300 Vir 'nia Avenue, Fort Pierce FL 34982 St. Lucie County
Phone: ( 72) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMI ',I APPLICATION FOR: Gas tank
Address: �3196 NW Wheaton LN
Legal Des Iription: Riverbend (PB67-36) :Pt 2
Property ax ID #: 4425-703-0007-000-4
Site Plan I ame: Riverbend Lot 2
Project ame: Riverbend Lot 2
I i
I Setback l Front Back:
Right Side: Left Side: _
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IInterior Exterior LP Gas lines and underground tank 250 gallon
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Additio' al work to bee rtormed u
11H I AC LJ Gas Tank
El E L ctric 1:1 Plumbing
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Total S Ft of Construction:
Cost of ! onstruction: $
4875.00
Lot No.
Block No.
tnis permit — cnecic au apply:
W]Gas Piping _ Shutters ❑ Windows/Doors
Sprinklers Generator 1:1 Roof Roof pitch
S�Ftj of First Floor:
Utilities: nSewer 0Septic Building Height:
Name tandard Pacific of FL Name: Cheyenne Elision
Add res' : 8895 N Military TrI 101 B Company: Propane Services Inc DBA Elite Gas Contractors
City: P 1 Im Beach Gardens State: FL Address: 2130 SW Poma Dr
Zip Co II e: 33410 Fax: City: Palm City State. FL
Phone No. Zip Code: 34990 Fax:
E-Mail Phone No. 561-722-1910
Fill in II a simple Title Holder on next page (if different E-Mail: Kgehrke@elitegasco.com
) County 18361
from t l e Owner listed above State or Coun License:
I
If valuel!1of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: it Address:
City: State: City: State:
Zip: Phone Zip: Phone:
i
FEE SIMP -E TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: I Phone: Zip: Phone:
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OWNER/ C 5 NTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that ilo work or installation has commenced prior to the issuance of a permit.
St. Lucie Couniflict
makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Ple 'se consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration n of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance J`nrith 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 str lLtures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING 11 O OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improveme its to your property. A -Notice of Commencement must be recorded and posted on the jobsite
before the irst inspection. If you intend to obtain financing, consult with lender or an attorney before
commencir E work or recordine vour Notice of Commencement.
Sign ure o
wner/ Lessee/Contractor as Agent for Owner
Sig ure of ontractor/License Holder
STATE OF
�LORIDA
STATE OF FLORIDA
COUNTY I
5F
COUNTY OF
The for oin
instru nt was acknowledged before me
The forgoing instru ent was acknowledged before me
this 201d' by
this d
of ssoi 2i by
i
—.—,?day of
Na
a of person making statement /
Name of person making statement
Personally
nown OR Produced Identification ✓
Personally Known OR Produced Identification
Type of Ide
I tifi,cation
Type of Identification
Produced
�
Produced WirI.1i
� r
naox. <� ° e� ANDA D. MCKIN
• �•,a D
e.
(Sig ture
f Notary , �- 'Ii°f sion #r FF930078
Signa ure of Notary ;•- bf FIQb I n��il f930076]
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MyCo e'�xpires Oct 22, 2019
No.
=�, P:P M Comm. Expir-�oFF�
Commission No. �'%%,°P ;�°`' y ICommissio
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
j
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17