HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL
INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
A V I" z$CANNED
BY '1Fc
Building Permit Application, �u �e Countw tr& ��F4
ing and Development Services
ng and Code Regulation Division )(��
e FL 34982
e+r772 462-1553 Faxnia Avenue, Fort C(772 462-1578 Commercial Residential 411�Nr
PERMIT
APPLICATION FOR: Gas tank l-
.PROPOSED
IMPROVEMENT LOCATION:
Legal
Site
8043 Plantation Lakes Dr
criotion: Reserve Plantation -Phase IIA-
.y Tax ID #: 3321-803-0045-000-7
n Name:
Name:
ks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Install1250 gallon LP tank to generator and final connect
Lot No.41
Block No.
CONSTRUCTION
INFORMATION:
Additional
[HVAC
work to be ertormed under this permit— check
Gas Tank ❑Gas Piping
a
apply:
Shutters
a Windows/Doors
l1
_
ME'lectric 0 Plumbing
❑Sprinklers
11 Generator
E]Roof Roof pitch
Total Sq. Ft of Construction:
S . Ft. of First Floor:
Cost ofj Construction: $ 1895.00
Utilities:
Sewer El
Septic
Building Height:
OWN�ERAESSEE:
CONTRACTOR:
Name
Address:8043
City: Port
Zip Codde:
Phone
E-Mail`
Fill in fI
from t
pavid & Gerry Vigrass
Name: Blake Cowdell
Company: Energized Gas
Address: 4252 Bandy Blvd
Plantation Lakes Dr
St Lucie State: FL
34986 Fax:
No.703-405-0658
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
E-Mail: EnergizedGenerators@gmail.com
State or County License: FL34747
a simple Title Holder on next page ( if different
e Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
N a m e: David & Gerry vigrass
Ad dress: 8043 Plantation Lakes Or
City: Port St Lucie State:
Zip: Phone
I
MORTGAGE COMPANY: _ Not Applicable
Name: Blake Cowdell
Address: 8o43 Plantation Lakes Dr
City: Fort Pierce State:
Zip: Phone:
FEE
Name,
AddeSs:4252
City
Zip:
SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Bandy Blvd
Address:
City:
Phone:
I
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I.certiiy that no work or installation has commenced prior to the issuance of a permit.
St. Lucre 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 Ownet;s 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 accoIrdance 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.
i
Signal ure of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORID ) '
COUNTY OF :�,1 C, COUNTY OFF
The f I rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of Sa�kw�h�,r 20� by �. ; this AT-c day of S. i. r- , 20 g b� I 17=
Name of per o making statement
Personally Known OR Produced Idl
Type of Identification
(Sign6turEJ of Notary Public- State of Florida )
Commission No. (Seal)
EWS
RECEIVED
DATEI
COMPLETED
Rev. 8/2/17
FRONT I ZONING
COUNTER REVIEW
IRFUm�
Name of p . rs n making statement
on"-w `�D
Personally Known X OR Produced Identification
Type of Identificatio
3=
3 m <
o t;n
Prod
D
n ov:�, z-2
N o G) zn (Signature c/f Notary Public- State of Florida )
O' G)027
NO W� _
_. m Commission No. (Seal)
y a°D0 Q D
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REVIEW