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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r� S Date: Permit Number: v I d S �VCJr`FO Building Permit Application �L�` Planning and Development Services St4g ��� Building and Code Regulation Division Z6�� �eob� 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Gas tank El PRO'POSED'I'MPROUEM.EN, LOCATION, Address: 238 Bimini Dr Legal Description: Coral Cove Beach -Section one- 9CANNED +� r '�r'�'9 I.tFSlA 9`�Paouw�ni Property Tax ID #: 1425-701-0045-000-7 Lot No.5 Site PIIan Name: Block No. 3 Project Name: Setbacks Front Back: Right Side: Left Side: , D:ETAIL'ED DESCRIPTION-O:F;WOR'K 4 Install250 Gallon Lp tank underground and gas lines to tankless water heater,dryer,range, and BBQ 'CON Sl RUCTION IN,FOR:NI�ATION.". ��i VAC Rj Gas Tank Electric 0 Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 4095.00 under this permit — cl ❑Gas Piping Sprinklers InappiY: _ Shutters ❑ Windows/Doors MGenerator El Roof Roof pitch Sq. Ft. of First Floor: Utilities: Sewer Septic Building Height: 01NNE"RLESSEE Vw CONTRACTOR Name iChristopher Workman Name: Blake Cowdell Address: 238 Bimini Dr Company: Energized Gas City: Hutchinson Island State: FL Address: 4252 Bandy Blvd City: Fort Pierce State: FL Zip Code: 34949 Fax: Phone No.772-539-1910 Zip Code: 34981 Fax: 772-318-6672 E-Mail: Phone No. 772-466-1095 E-Mail: EnergizedGenerators@gmail.com Fill in fee simple Title Holder on next page ( if different State or County License: FL34747 from the Owner listed above) I IT value oT construction is >Lsuu or more, a KECURDED Notice of Commencement is required. SURIp%, ENTAL CONSTRUCTI(QNaI:I N LAW INF RMTIU,N IA h m_.. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Christopher Workman _ N a m e: Blake Cowdell Address:238Biminior Address: 238BiminiDr City; Hutchinson State: City: Fort Pierce State: Zip � Phone Zip: Phone: FEEi SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: 4252 Bandy Blvd Address: City: City: Zip: Phone: Zip: 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 your Notice of Commencement. 10L J we of Owner/ Lessee/Contractor as Agent for Owner Sign ure of Contractor/License Holder COUNTY OF ORIDA5�, (r elk � COUNTSTATE OF FLY OF ORIDA�� l The forgoing instrument was acknowled@ this &t day of Sj20 Name of pers n making statement Personally Known OR Produced Id( Type of Identification of Notary 1305fic- State Commission No. before me I The by this da ) (Seal) ing instrument was acknowledged before me day of 15-4,Q_A1C , 20& by e ���0�` n%��•• y Name of pe so making statement Personally Known OR Produced Identifica 'on Type of Identification %? K 3 1— ProducRd �o3•aC/�i to a3 �� C � � TD _ X3O 0•W �y Ny Poo '�`� D (Signature of otary Public- State of Florida) N m N� G) Nx ^'� c = Commission No. (Seal) y y 00 P> REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE i RECEIVED DATE COMPLETED Rev. 8/2/17 co