HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Dates: 10—Lco— Permit Number: L&Q- 031
SCANNED
Building Permit Application BY
Planning and Development Services St LUCl2 County
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
�r
�RROPOS`ED`IfVIPRO�/EMENT LOCATION.
Address: 5513 Hickory Dr
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Legal Description: Indian River Estates -Unit 08-
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Propefty Tax ID #: 3402-609-0212-000-1
Site Plan Name:
Projecll Name: Vencill
Setbacks Front Back:
Right Side: Left Side:
Instal[420 model LP tank -e—
Lot No.34
Block No.
Aaam nal work to De ertormea under this permit — cneck all apply:
�HVAC Gas Tank Gas Piping _Shutters Windows/Doors
0 Electric 0 Plumbing Sprinklers E Generator E]Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1695.00 Utilities: Sewer Septic Building Height:
01lUNtER/,LESSEE a ,,m
°h'irF�{ Yx . l:3dw&
CONTRAC
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Name 'Joe & Carol Vencill
Address:5513 Hickory Dr
Name: Blake Cowdell
Company: Energized Gas
City: Fort Pierce State: FL
Zip Code: 34981 Fax:
Phone INo.772-466-1095
E-Mail,:
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
I
Address: 4252 Bandy Blvd
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
it value lot construction is $7500 or more, a RECORDED Notice of Commencement is required.
SOPPLE`MENTALCON'STRUCTION LIEN. LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: Joe & Carol Vencill
_
Name: Blake Cowdell
Address:5513 Hickory Dr
Address: 5513 HickoryDr
Cityl; Fort Pierce State:
city: Fort Pierce State:
Zip:', Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Add ress: 4252 Bandy Blvd
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
comajeng,ing work or recording our Notice of Commencement.
Ili
Si of Owner/ Lessee/Contractor as Agent for Owner
Sig e o Contractor/License Hol r
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STATE OF FLORIDni.
STATE OF FLORIDA " Q
COUNTY OF 1 (A( �1 h
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COUNTY OF I . U
The forgoing instrument was acknowledged before
he forgoin instrument was acknowledged bbfore me
this day of 200 by `111� I/'
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Name of pemaking statement
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Name of pers n making statement
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Personally Known OR Produced Identificati
ersonally Known OR Produced Identification
Type of Identification
ype of Ide tification
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(Signature f Notary Public- State of Florida) N m N m
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otary Public- State of Flori a)
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Commission No. (Seal) m
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17