HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
08/31/2018 Permit Number:
RECENED v
Building Permit Application 1
d
ning and Development Services SFp
ling and Code Regulation Division
Virginia Avenue, Fort Pierce FL 34982 permitting Department
ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentialt )ecie County
�I
MIT APPLICATION FOR: Gas tank
�)POSED IMPROVEMENT LOCATION:
ss: 4876 Watersong Way Ft. Pierce, FL 34949-9207
Description: Watersong PUD Plat #1, Lot 50
Prof, rty Tax ID #: 253250000640001
Site Ian Name: Medina
Proj' ct Name: Medina
Set',, cks Front Back:
Right Side: Left Side:
Lot No. 50
Block No.
DETAILED DESCRIPTION OF WORK: 'I
250 gallon LP tank, UG gas Lines,,_ and final connections to Generator, Range,
& Fireplace
CONSTRUCTION
INFORMATION:
bona work to e e orme under
�i, (j� j
HVAC LJ Gas Tank
this permit— check
W]Gas Piping
a apply:
_ Shutters
a Windows/Doors
Electric 0 Plumbing
Sprinklers
E Generator
11 Roof Roof pitch
Total
q. Ft of Construction:
S Ft. of First Floor:
Cost'
f Construction: $ 2485.00
1
Utilities:LiSewer Septic,
Building Height:
OW
i ERAESSEE:
CONTRACTOR`:
Nam"
Addr,
City:
Zip Clde:
Phoni
E-Ma
Fill in'
from
II
Name: Paul Drag6;
Company: Paulie Propane & Natural Gas Systems, Inc.
Address: 4100 SE Salerno Road
ss:
State: _
Fax:
No. �2 ('/
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No. 772/220-2616
E-Mail: pauliepropane@gmail.com
State or County License: 24441
,OS
I:
ee simple Title Holder on next page (if different
��he Owner listed above)
.
IT vaiuq or construction is $25oD or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL
CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
N'
A
CllIy:
Ziq:
_ Not Applicable
Ime:
MORTGAGE COMPANY: _ Not Applicable
Name: Paul Dragi
d ress: 4876 Watersong Way Ft. Pierce, FL 34949-9207
Address:
State:
Phone
City: Stuart State:
Zip: Phone:
FETE SIMPLE TITLE HOLDER: _ Not Applicable
N'`��Ime:
BONDING COMPANY: Not Applicable
Name:
Address:
AQdress: 4100 SE Salem. Road
CI �/:
City:
Zi
Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I cehify that no work or installation has commenced prior to the issuance of a permit.
I.
St. Li cie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
whic i is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
stru ure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In con sideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in ac-ordance 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,
LI
accelFry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WA II NI O OWNER: Your failure to Record a Notice of Corr?men ment may result in your paying twice for
imp o emen s to your Rroperty. A Notice of Commencement musl be recorded ano posted on the jobsite
bef the fir t ins a on. If you intend to obtain financing, consu t with lender or an attorney before
Corr m encing o r 'ording yoKNotice of Commenceni ent.
n J _
Owner/
Agent for Owner I Sign
STATE OF FLORIDI f
CO NTY OF I� YP'(A
The forgoing instru t was ackn ledged before me
this day of 201!� by
Name of person making statement
Personally Known �� OR Produced Ide` wo'll
Typ of Identification \\���P'(I_ ST •No F "'�✓ion
Proiluced ��` 4• •�\SSIONFIA.• �;
of Notar�P`ubblic- State of
i NoA 6`3oU
RE�IIEWS I FRONT I ZONING
II COUNTER I REVIEW
COMPLETED
Rev. 8j2/17
STATE OF FLORIDA AlNTY OF �' f 4(10
The forgoing instru ent as ac owledge before me
this y of � �A.�ll. 20� by
Name of persop4aking statement
Personally Known OR Produced Identification
Type of Identification
STO'
G.•••\SSIOIV •'•.
�Ober3,?xOy
; 02 (Signature of Notary P bli State oFWiSaA/71`�
F��I; �:� • p`t����� #FF909203 :ae
ICIC, Commission No 0 q•. � Qded0\0��Zh� oQ,
if11N11111 p�!BCICrST��~�\
SUPERVISREVIEWOR I REVIEW I PLANSV REVIEEGETATIW REVIEW
I S EV EWLE I ANGRO
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