HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED zr
Da ie: T3 N �� Permit Number: 0 lb 0 5A S
- l BY RECEIVED
Lude County,
Building Permit Application AUG 2 3 2018
ing and Development Services
ng and Code Regulation Division ST. Lucie County Perinittlrl
Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERIMIT APPLICATION FOR: Gas tank ;=
PROPOSED
IMPROVEMENT LOCATION:
Addr`1ss:
9417 Pinebark Ct
Legalescription:
Monte Carlo Country Club- Unit One-
Prop lhty
Tax ID #: 1327-801-0045-000-3 Lot No.156
31Le rian MUM.
Proiect Name:
cs Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Connect existing gas line to generator and final connect
CONSTRUCTION INFORMATION: .
iti I bnal work to be
� performed
orme under this permit— check all apply:
❑HVAC LJ Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
OlElectric Plumbing USprinklers Generator 13 Roof Roof pitch
Total �iq. Ft of Construction: _
Cost of Construction: $ 395.00
S Ft. of First Floor: _
Utilities: Sewer E]Septic
Building Height:
OWN DER/LESSEE:
CONTRACTOR:
Namebonald & Silvia Westover
Name: Blake Cowdell
Company: Energized Gas
Addresls:9417 Pinebark Ct
City: Fort Pierce State:FL
Address: 4252 Bandy Blvd
City: Fort Pierce State:FL
Zip Coe: 34951 Fax:
Phon'+0.740-815-2791
Zip Code: 34981 Fax: 772-318-6672
E-Mail-
Phone No. 772-466-1095
E-Mail: EnergizedGenerators@gmail.com
State or County License: FL34747
Fill in fie simple Title Holder on next page ( if different
from tide Owner listed above)
If valuejof construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
a0l. State:
Zips Phone
FEE
Name:
Address:
City:
Zip!
I
SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Phone:
Zip: Phone:
OWNER/
CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify
that no work or installation has commenced prior to the issuance of a permit.
St. Lucie
whichIlls
County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
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 conlsideration
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,
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
befo 'le
the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing
work or recording our Notice of Commencement.
I
I
U--- Cow dj,&
� 1,1 /1 �L
Flaju, ok—,v
—
of Owner/ Lessee/Contractor as Agent for Owner
Sign Ire
Signature of Contractor/License Holder
STATE OF FLORIDA�� r
STATE OF FLORIDA \
COUNTY OF ���1"- _C Y i C,
COUNTY OF � � . __U_� 1 e ,
The f oing instrument was cknowledged before m
this ',' day of 20�by ,.�������,day
Vef ing instr ent was cknowledged before me
of 20 by
�i
Name of pers n making statemen
Known OR Produced Identification
''%?„��,IName
�
TP
of son making statementPersonally
sonally Known OR Produced Identification
Typeof
Identification
c�
3 m
d
e of Identificationd
IE_
(-03• SL
Ce
3 y R'DAbvl30007
IV .:0 NO
PJAI��i 6"
Z(Signatur
of Notary Public- State of Florida)
N
(
nature Notary Public- State of Florida
Com ission No. (Seal)
0.
y 00 C
V _.
S
M
mmission No. (Seal)
NX
N
FRONT I ZONING SUPERVISOR I PLANS VEGETATION I SEA TURTLE I MANGROVE
COUNTER I R I REVIEW I REVIEW I REVIEW REVIEW REVIEW
DATE
RECE
COMPILET
Rev. 8/2/17