HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,r-
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
I'I
Da e: 8/�18 Permit Number: �.
• RECEIVED
Building Permit Application
Pla►►n►ng and Development Services AUG 10 2018
Bull�ding and Code Regulation vision
ST. Lucie County, Permitting
2309 Virginia Avenue, Fort Pierce FL 34982
Ph q�e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PER1} IT APPLICATION FOR: Gas tank
PROPOSED 'IMPROVEMENT LOCATION: A
Addr 'Iss: 12351 Cessna Terrace, Port St Lucie, FL
Legal1,Description: Air park of Port St Lucie Lot 45
NL17Z4 so i
42 24 501 0045 000 5 45
Prop irty Tax ID #: Lot No.
Site F Ian Name: Boundary survey Block No.
Projelit Name: Varga residence
Setb ,cks Front 150' + Back: 130' Right Side: 100'+ Left Side: 150'+
I' DETAILED DESCRIPTION OF WORK:
instal 500 gallon LP tank and 25' of line to new generator (installed by others)
CONSTRUCTION INFORMATION:
i Iona workto e�jje orme under this permit -check a apply:
HVAC LJ Gas Tank Gas Piping _ Shutters Q Windows/Doors
RI
(Electric ❑_ Plumbing Sprinklers Generator ' Roof Roof pitch
Total qConstruction:$
Ft of Construction: S . Ft. of First Floor:
Cost '�f 2400 Utilities: _Sewer Septic Building Height:
OW
!ER/LESSEE:
CONTRACTOR:
Nam
I VAra Wi I1tAm AWh AAAAra
Name: Brian Critoph
ss: 19351 Cc 5sw h TGrr ffcF
Addr
Company: C and C Diversified
ST. Lint E ; State: FL.
City:
Address: 7954 SW Jack James Dr
Zip C%de:
Phon
I?QCA-
30 8 i Fax:
I No. 7*7 a - l0 3 ► - g y 47
City: Stuart State: FL
Zip Code: 34997. Fax: 772-266-4679
V a i G. Cio rA
E-Marl:
Phone No. 772-266-4680
fee simple Title Holder on next page ( if different
(he Owner listed above)
Fill in
from
E-Mail: info@ccdiversifedgas.com
State or County License:-;5*9ftounty / 21079 state
.1
S5 CN
it value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
State:
Phone:
I I
FEE
Naml'
Add
city:
Zip:
SIMPLE TITLE HOLDER: _ Not Applicable
:
BONDING COMPANY: _Not Applicable
Name:
ess:
Address:
City:
i
.I Phone:
I I
Zip: Phone:
that no work or installation has commenced prior to the issuance of a permit.
St. Lu ie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
struct re. 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 acc'rdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The f illowing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory 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
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comrhenciniz work or recordine vour Notice of Commencement.
'_- ./ff A!= /y! 4<& s
Signa bre of Owner/Lessee/Contractor as Agent for Owner Signature of Contra cto icense Holder
STA E OF FLORIDA y� ,�� STATE OF FLORIDA
COUNTY OF COUNTY OF ,�/�liI"1r1�7
The f 'r oing instrum t was acknowledged before me
this day of Z!� 200/QE-by
li
of person acknowledging)
fgnature of Notary Public- Stafe of Florida )
Personally Known !/ uce IdAPritific�fi
Type of Identification Pro � ': MYco'WWSrON FF
sonde hlu otaryPublic Underwriters it
Commlssion No. ,>1 ,�'_ _ _
Ne
07/15/2014
The forgoing inst=�C/
acknowledged b fore me
this _r day of 20 ?by
i
(Name of person acknowledging )
(Si ature of Notary
�Public- StatLfof Florida )
Personally Known !/ OR Produced Identification
Type of Identification Produced
Commission No.
JAMES W. PAUGt 11
(8
l8Q$MMISSI0N # FF 944078
EXPIRES: January 21, 2020
Bonded Thru Notary Public Underwriters
REVIEWS
11
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
LI
COMPLETE
INITIAS
Sll�kPIEIVIEN`fAL
rt
�,. ,� v �. �, � .e� '� ,,.. -� �
C..NST{yRUCTION L�EN4LAW 1'NCRN)iATINaY5�rt
Y Y,. � � � '1 �+te"3! '� t) �r4'l`:.. . .5h,� y 4f, �, a.S �� d S � � t�i A:
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DE
IGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Na
Ad
e.
_
Name:
Address:
ress:
Cit
zip:
City: State:
Zip: Phone:
t State:
,l Phone:
�I
FE0
Name:
IMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: —Not Applicable
Name:
Address:
Address:
Cit
Zip:;
�
City:
Phone:
Zip: Phone:
I certify that no work 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
whit is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
stru lure. 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 accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The IIIllowing building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAII NING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on. the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
com'mencine work or recordine vour Notice of Commencement.
as Agent for Owner
7I.M I,G�Vr f LV,RI V/1,_ . _. '� `.":•:�f_s,`;5t..>S-Si.;�.}'
CO "NTY OF „'.
The forgoing.. instrument was acknowledged before me
this, I�'� ` ' day of , 20 _by
Nar>i;e of person acknowledging
Tce ofzNotary:;Rublic-_State;of.Florida )
Ily Known OR Produced 'ldentificati6n`
Identification Produced r
07/15/2014
iffA=-zL& s
Signature of ContractorfLicense Holder
STATE OF FLORIDA
COUNTY OF ,//�riI''Ti�!
The forgoing instrum t was acknowledged b fore me
this _r day of 20 by
�O�i
(Name of person acknowledging)
(Si ature of NotaryPublic- Stat , F Florida )
Personally Known 11�OR Produced Identification
Type of Identification Produced
JAMESW. PADGETT
Commission No. (®iEMISSION # FF 944078
= EXPIRES: January21, 2020
^;•'�:
.;� •:,,dS••' Bonded ThruNotary public Underwriters
REVIEWS
FRONT .
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
•
III
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
.DATE
COMPLETE
INITI�II
LS