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APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
te: Permit Number: M03 -D 33
SCANNED
_ BY
� St. Lucie ftntVRECENED
Building Permit Application Allf, ® 9.2018
ruing and Development Services
Permitting Department
Iding and Code Regulation Division Perst. Lucie County
10 Virginia Avenue, Fort Pierce FL 34982
)ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential I'D
IMIT APPLICATION FOR: r-
Gas tank L_'
)POSED IMPROVEMENT LOCATION:
'ess: 9401 Avenel Ln
I Description: Pines at the Reserve Lot 13 ( OR 1133-1875; 3935 -756)
ierty Tax ID #: 3322-502-0019-000-5
Plan Name:
act Name: Bullis
Jacks Front Back: _
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Corjrlect generator to existing gas line and final connect
Lot No.13
Block No.
CONSTRUCTION INFORMATION:
itiona workto e e orme under this permit —check a apply:
�� HVACGas Tank ❑Gas Piping In _ Shutters ❑ Windows/Doors
II Electric Plumbing Sprinklers En Generator g Roof Roof pitch
Tot I Sq. Ft of Construction: S . Ft. of First Floor:
Cos of Construction: $ 9900.00 Utilities: Sewer Septic Building Height:
I
O
NER/LESSEE:
CONTRACTOR:
Na�jeRandy
Address:9401
Bullis
Name: Blake Cowdell
Company: Energized Gas
Avenel Ln
Port Saint Lucie State: FL
Code: 34986 Fax:
a No. 772-466-6795
Cityl�l
Zip
Pho'i
Address: 4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
E-ail:
Phone No. 772-466-1095
�I fee simple Title Holder on next page ( if different
Fill
E-Mail: EnergizedGenerators@gmail.com
fro
I the Owner listed above)
State or County License: FL34747
If va'ue of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable
MORTGAGE COMPANY: _ Not Applicable
N�a me: Randy BuHis
Name: Blake cowdell
Ai' dress:9401 Avenel Ln
Address: 9401 Avenel Ln
ty: Port Saint Lucie State:
City: Fort Pierce State:
Z p: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
A dress:42528andyBlvd
Address:
C ty:
City:
Z'p: Phone:
Zip: Phone:
01 INER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I c rtify that no work or installation has commenced prior to the issuance of a permit.
St. �ljlucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
whi h is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
stri cture. Please consult 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 accordance with 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,
acc �ssory 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
More the first inspection. If you intend to obtain financing, consult with lender or an attorney before
mencine work or recording vour Notice of Commencement.
I
- K;i� ajj"
of Owner/ Lessee/Contractor as Agent for Owner Sign re of Contractor/License Holder
NTY OF ORIDA �� � ILL
I COUNTY OF ORID iSTATE OF ��1(A e.
forgoing instrument was acknowledged before me
7 day of Avau S f' , 20JI by
_% ► ,, V „ 2 1 1
Name of pe s n making statement
orally Known OR Produced Id(
of Identification
of Notary Public- State of Florida )
No.
(Seal)
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c 0 3 o G
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Ny-3?r
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06 C m
Vl CO a-
The forgoing instrument was acknowledged before me
Lhis -- day of fluGU S f , 20A by
Name of p s n making statement
rsonally Known J,,1 OR Produced Identification
Pe of Identification
of Notary Public- State of Florida )
i No. (Seal)
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N N yk N
IEVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
R
CEIVED
D
7E
C6MPLETED
Rev.18/2/17