HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONN
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED` `
Date: 08/31/2018 SCANNED Permit Number:12f)q - l.� J
BY
Building Permit Application SEp ® 101e
Planning and Development Services a�er+t
euibing and Code Regulation Division Qerrr,�tt�n9 �ew IV
23C0 Virginia Avenue, Fort Pierce FL 34982 St. LOUQ
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PE ;,EMIT
APPLICATION FOR: Gas tank
PROPOSED
IMPROVEMENT LOCATION:
Address:
4884 Watersong Way Ft. Pierce, FL 34949-9267
Lega;
Waterson
Description: 9 PUD Plat #1, Lot 52
Prop
253250000680005 52
Tax Tax ID #: Lot No.
Site
Ilan Name: Halbert
ProjE!
Block No.
Name: Halbert
acks Front Back: Right Side: Left Side:
Sethi
[_D_qA_ILED
DESCRIPTION -OF WORK:
Inst III
500 gallon LP tank, UG gas Lines
I
'
CONSTRUCTION
"6
INFORMATION:
Add itiona I work to be ne orme under this permit —check a apply:
li HVAC LJ Gas Tank Gas ing Shutters
Pi
WindowsElectric
P / Doors
—13
PlumbingSprinklers OGenerator
Roof Roof pitch
IS
Tota Ft of Construction: S . Ft. of First Floor:
R
Cost �f Construction: $. 2485.00 Utilities: _ Sewer Septic Building Height:
0 NQAESSEE:
CONTRACTOR:
Nam
Name: Paul Drag'-.
l�j
Address:
Company: F'aulie Propane &Natural Gas Systems, Inc.
City: G
State:
Address 4100 SE Salerno Road
Zip II de: Fax:
City: Stuart State: FL
Pho a No. ��� rla
I q
Zip Code: 34994 Fax:
E-Mi il:
Fill ii ilfee Title Holder
Phone No. 772/220-2616
pauliepropane@gmail.com
simple on next page ( if difff nt
from,11the Owner listed
E-Mail:
24441
above)
!
State or County License:
Illy vajue or consirucnon Is ;sc5uu or more, a KtcUKUtU Notice of commencement is required.
SUPPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION:
DE
Nape:
Address:
Cit
Zip
IGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Paul oragi
4676 Watersong Way Ft. Pierce, FL 34949-9207
Address:
City: Stuart State:
Zip: Phone:
' : State:
Phone
FEE
Na,-ne:
Address:
Cit,
Zip:
SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
4100 SE Salemo Road
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 cerltify that no work or installation has commenced prior to the issuance of a permit.
St. Ltic[e 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
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In co a sideration 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 f [lowing 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
I
WARNING TO : Your failure o Record a Notice of Commennere
y result in your paying twice for
improvemen to you roperty. A otice of Commencement mrded an posted on the jobsite
before the fist inspecti n. If you i tend to obtain financing, connd r o a attorney b ore
commenci work or re oOing y ur Notice of C mmencement.
4k _ l
STATE OF FLORID/ /�
COUNTY OF � Y
instrurAent s. acWowledgeA before me
of 20by
Name of person akirCst ement
onally Known VOR Produced Identification
of Identification `,N11111111101,
VL STO
luced ,DER•• N�c i,�
••.�,\SSIONF �
�ber3, �A� •;
j`
t
iature of No ry ublic- State oil riday�)�#FF 909203 So
mission No. �3,Dfecunb;:¢���'�Q�
,/ s�,, N1C �S10\\§��
STATE OF FLORIDA V
COUNTY OF K�11n
The forgoing instrtiment was aFknowledged before me
thisl,-�-(d�y of ` r 20�& by
Name of person ing statement
Personally Known OR Produced Identification
Type of Identification \�`�111111illlJl/p��
Produce ,�VL SToN /���i
,\SSIolve
tuber 3,
CP
(Signature of Notaryub - Stated rorida
s 2 ; # F 909203 : o¢
Commission No. �"10��� ��i9` �un�;:
.RI
R 'VIEWS
FRONT
ZONING
SUPERVISOR
PLANS'
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17