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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 33 -< C_ 0 3• cn S3D .W D y= r SUPERVISREVIEWOR I RE VIEW LANS I VEGETATIEVIEWON I SEREV EWLE I MANGROVE REVIEW