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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED : 9i20/18 a1� dU
3Datp
• - RECEIVED
Building Permit Application
Pla iing and Development Services S E P � 0 r` 018
Bull Ying and Code Regulation Division
ST. Lucie County, Permitting
230 1 Virginia Avenue, Fort Pierce FL 34982
Ph I� e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PER IT APPLICATION FOR: Gas tank�I���9j
PR POSED IMPROVEMENT LOCATION: By
Addr ss: 12451 Piper Cub Terrace, Port St Lucie mi I y
Legal Description: TC Airpark Lot 89 (2.31 AC)(OR 1021-1187:2865-2845: 3845-92 )
Propi rty Tax ID #: 4224-501-0089-000-5 Lot No. 89
Site R an Name: Driver survey Block No.
Projet Name: Driver residence
Setb 11 cks Front Back. Right Side. Left Side:
DETAILED DESCRIPTION OF WORK:
insta 1 (2) 100 gallon above ground LP tanks, manifolded together, and gas line to new generator
insta Med by others (generator permit 1803-0145)
COOSTRUCTIO:N
INFORMATION:
AdchMonal
work to be ne orme under this permit — check
Gas Tank ZGas Piping
a
apply:
Shutters
Q Windows/Doors
HVAC
LJ
_
Electric ❑ Plumbing
Sprinklers
ElGenerator
Roof Roof pitch
Total
q. Ft of Construction:
If 1800.00
S . Ft. of First Floor:
Cost
Construction: $
Utilities. Sewer Septic
Building Height:
O.W
ER/LES'SEE:
CONTRACTOR:
Nam
Driver, Stuart S
Name: Brian Critoph
Addr
Company: C and C Diversified
Iss: 12451 Piper Cub Terrace
ort St Lucie State: FL
City:
Address:, 7954 SW Jack James Dr
Zip
i de: 34987 Fax:
City: Stuart State: FL
Phonee
E-M
No.
Zip Code: 34997 Fax: 772-266-4679
Phone No. 772-266-4680
evil:
fee simple Title Holder on next page ( if different
Fill ir
E-Mail: info@ccdiversifiedgas.com
from
'I he Owner listed above)
State or County License: state lic#21079
If valoo of construction is $2500 or more, a RECORDED Notice of Commencement is required.
i
S'UPhEMf'NTA'L'CONSTRUCTIO'N
LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Nam'i:
Address:
City:
Zip:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
State:
11 Phone: -
I I
FEE SIMPLE
Nam
Address:
City:
Zip:
TITLE BOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
'I
19 Phone:
11
Zip: Phone:
I certi'y that no work or installation has commenced prior to the issuance of a permit.
St. Lu le 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
struct re. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In co sideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acc''rdance 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
WAFT ING 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''Ie the first inspection. If you intend to obtain financing, consult with lender or an attorney before
comrhencing work or recording vour Notice of Commencement.
s
Signa lure of Owner/ essee/Contractor as Agent for Owner Signature of Contract/License Holder
STATE OF FLORIDA/�� r STATE OF FLORIDA
COU TY OF �!%�r1 COUNTY OF ��/'L/h
The forgoing instrujnentyvas acknowledge before me The forgoing instrument was acknowledged before me
this day of �. 20�y this day of r 20/�by
IF r
of person acknowledging
re of Notary. Public- Stare of Florida )
Y
Persd'Ibally Known OR Prod
Typelof Identification Prod
Commission No.
d 07/15/2014
V'y COMMISNvry r rr 1T,.,,
Bondd�� ;January 21,2020
edAYNotary Public Underwriters
A, 'e!� e"
(Name of person acknowledging )
X�� 'It." �45Zg�zl
gnature of Notary Public- State of Florida )
Personally Known P OR Produced Identification
Type of Identification P
=5i�?rff. our
MY C0M ISSIC # FF 944078
Commission No. S.
EXPIRE -Qu n'21,2020
4a Fyq? ' Bonded Thru Notary Public Underwriters
RE I
IEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DAT
OM CPLETE
INITIALS
I'I