HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
I i
ALL
MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number: v5 L
CAN
NED
5y
Building Permit Application Ivi Lude.,County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Gas tank F-
PROPOSED IMPROVEMENT LOCATION:
Address: 626 SE Hidden River Dr
Legal Description: Hidden River Estates
Propel y Tax ID #. 3427-701-0028-000-4 Lot No.4
Site Plan Name: Block No. 2
Proje It Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Instaill 250 gallon LP tank to generator and final connect
CONSTRUCTION INFORMATION:
Additional work to e ne orme under this permit— check a apply:
1 VAC Gas Tank ❑Gas Piping, _ Shutters ❑ Windows/Doors
❑ lectric 0 Plumbing ❑Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2895.00
S Ft, of First Floor: _
Utilities: —Sewer ❑Septic
Building Height:
OWN
ER/LESSEE:
CONTRACTOR:
Name JThomas Maynard
Name: Blake Cowdell
Address:626 SE Hidden River Dr
Company: Energized Gas
Address: 4252 Bandy Blvd
City: Port St Lucie State: FL
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Zip Code: 34983 Fax:
Phone No.772-380-6911
E-Mail:
Phone No. 772-466-1095
E-Mail: EnergizedGenerators@gmail.com
Fill in iee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: FL34747
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Thomas Maynard
Name: Blake Cowdell
i
Ad dress: 626 SE Hidden River Dr
Address: 626 SE Hidden River Dr
City: Port sc Lucie State:
City: Pert Fierce State:
Zip: Phone
I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:4252 Bandy Blvd
Address:
City1i
City:
Zip: Phone:
Zip:l 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 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 consideration 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
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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TJ LA-.1
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
OF (,(�
STATE OF FLORIDA
COUNTY OF
COUNTY
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The forgoing instrument was acknowledged beforErri4e-
The forgoing instrument was acknowledged before me
this day o 201 by ,;;5'�'Y,or;
this J33 day of 20 by
o°"""`�;,
la Cni'6,
Name of pers making statement
Personally Known OR Produced Identifica
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ame of pers making statement =
Personally Known OR Produced Identification
Type of Identification
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(Sign�tu a of Notary Public- State of Florida) N X N ,' cn
(Si natu e f Notary Public- State of Florida) N o z
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Commission No. (Seal) y CO`c D
07 O
GCommission No. (Seal) "'a
-4
v v
y CD O C
0
I
REV`EWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATEI
RECEIVED
DATE
COMPLETED
Rev. 8/2/17