HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Da e: O U Permit Number:
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4- RR E C lmI XV Kif
�w Building Permit Application SEP 12 2018
PlaiiningandDevelopmentServices PermittingDepartment
BuiLIing and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. LU County, FL
Ph Ine: (772) 462-1553 Fax: (772) 462-1578 Commercial Re
PE IT APPLICATION FOR:
�,� Gas tank SCANNED
PROPOSED IMPROVEMENT LOCATION: g
Addr ass: 1300 NW Lancewood Terr St Lucie County
Legal'Description: Harbour Ridge- Plat 9- Lancewood Village Unit 1
PropIFty Tax ID #: 4426-804-0011-000-8
Site Plan Name:
Proie It Name:
Setb I Icks Front Back: Right Side: Left Side:
DET ICED DESCRIPTION OF WORK:
Instal' 500 gallon LP tank to generator and final connect
Lot No.
Block No.
CON• TRUCTION INFORMATION:
-Adit na wor to ee e orme under this permit— c ec a app y:
�2AC Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
❑_ Electric 1:1 Plumbing Sprinklers E] Generator Roof Roof pitch
Total Slq. Ft of Construction: S . Ft. of First Floor:
Cost o� Construction: $ 3300.00 Utilities:In Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Addre
City:
Zip Code:
Phone
E-Mail
Fill in f
from thle
Poan Nartowt
Name: Blake Cowdell
Company: Energized Gas
Address: 4252 Bandy Blvd
,�s:1300 NW Lancewood Terr
lalm City State: FL
34990 Fax:
0.772-873-4560
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
a simple Title Holder on next page ( if different
Owner listed above)
E-Mail: EnergizedGenerators@gmail.com
State or County License: FL34747
If value §f construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
D
N IlIfTle:
A
Cit'
Zi�II:
LS__IGNER/ENGINEER: _ Not Applicable
JoanNaIt wt
MORTGAGE COMPANY: _ Not Applicable
Name: Blake Cowdell
Address: 1300 NW Lancewood Terr
a ress:1300 NW Lancewood Terr
r: Palm City State:
Phone
I
City: Fort Pierce State:
Zip: Phone:
FE� SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Adld ress:4252 Bandy Blvd
Cit�11:
City:
Zip: Phone:
Zipll Phone:
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ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
fy that no work or installation has commenced prior to the issuance of a permit.
ie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
ire. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
sideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
irdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
Ilowing building permit applications are exempt from undergoing a full concurrency review: room additions,
ory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
KING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
wements to your property. A Notice of Commencement must be recorded and posted on the jobsite
e the first inspection. If you intend to obtain financing, consult with lender or an attorney before
iencine work or recordine vour Notice of Commencement.
I
I
Sign �Iture of Owner/ Lessee/Contractor as Agent for Owner
Signa e of Contractor/License Holder
ur
ST TE OF FLORID
STATE OF FLORIDA
CO NTY OF �IC GL
COUNTY OFtl� ,L C a
The rgoing instrument was acknowledg efore me
The forgoing instrument was acknow ledg , before me
this day of 20 by
this day of 20 by
_
n V Q r Lt'yce H
ye . 4
Pers
Name of pers making statement =�
I nally Known A, OR Produced Identification %�a ,o
<= Name of per making statement'
sonally Known OR Produced Identification
Typ 'of
anra•
Identification C
T e of Identification
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(Sig
ature f Notary Public- State of Florida) N o' "z
ignatur of Notary Pu ic- State of Florida)
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fission No. (Seal) nio w<
mmission No. (Seal)
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RE
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
VIEWS
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATqJ
RECEIVED
DATE
COM
'o LETED
Rev. 8/E/17