HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL A I PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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DaterNND Permit Number:
' y ''BY RECEIVED
;�. Building Permit Application AUG 10 2018
Plan fng and DevelopmentServices ST. Lucie County, permierin
Build ng and Code Regulation Division
230Q Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRO .OSED IMPROVEMENT LOCATION:
Addre ss: 5710 Paleo Pines Cir
Legal I, escription: Holiday Pine Subdivion Phase 1 Plat Book 18 Pgs 16-16a to D
Prope'1 Tax ID #: 12-500-0029-000-5 Lot No. 28
Site Pllan Name: Block No.
Proje't Name:
Setb cks Front Back: Right Side: Left Side:
OET IL'ED DESCRIPTION OF WORK
Insta1(11500 gallon LP tank to generator and final connect
CON TRUCTION INFORMATION:
Addil Inal work to be oerformed under this permit— check all apply:
i
HVAC Gas Tank Gas Piping fn Shutters a Windows/Doors
Electric ❑_ Plumbing ❑Sprinklers El Generator Roof Roof pitch
Total Iq. Ft of Construction: S . Ft. of First Floor:
{ 3200.00
Cost f Construction: $ Utilities: _ Sewer 0 Septic Building Height:
.qW
ER/LESSEE:
CONTRACTOR;
eOoy
Name.
Addr
City:
Zip C
Phon
E-Mail:
Fill in
from
Hudson
Name: Blake Cowdell
ss.5710 Paleo Pines Cir
Company: Energized Gas
fort Pierce State: FL
i de: 34951 Fax:
No'772-971-6365
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
fee simple Title Holder on next page ( if different
the owner listed above)
E-Mail: EnergizedGenerators@gmail.com
State or County License:T
If valuo of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION:
DESIG
Name:
Add r
City:I
Zip:.]
I NER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
less: 5710 Paleo Pines Cir
State:
Phone
FEE
Name:
Address:
City:
Zip:
'IMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Phone:
Zip: Phone:
OWNI R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certi that no work or installation has commenced prior to the issuance of a permit.
St. Lucile County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. 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 acco (dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fol owing 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
befor,the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comncing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STALE OF FLORIDA I
� STATE OF FLORIDACOUNTY OF t I COUNTY OF
The f�, rgoing instrument was acknowledged before me
this day of }Q9jJ5 — 20 f t by Tr=
Name of pers n making statement
Ily Known OR Produced Idi
Identificatio
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C3_a5>
'`30M.CD
The forgoing instrument was acknowledged before me
this day of Sf - 201 8' by
mom;
Name of pe s making statement
Personally Known OR Produced Identificati
Type of Identification � 3 r-
Produced ` 03 0(n
E3D
'�3c°oo
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Signatu a of Notary Public- State of Florida) N 3 m (Sign a of Notary Public- State of Florida) N X N
NX W.01 fn D W<
Commission m
ission No. (Seal) c-um Commission No. (Seal) m
yr mCal D
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a
RE ' IEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECIJIVED
DATE
Rev.8/2/17