HomeMy WebLinkAboutappAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:` ,ZT Permit Number: 1✓ I
RECEIVED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Gas tank
IIE F'ROPASEb IMPROVEMENT LOCATION:
JUN 2 5 2019
Building Permit Application ST. Lucie County, Permitting
Commercial
Address: 2675 Twin Oaks TRL Fort Pierce, FL 34945
Property Tax ID #: 2322-411-0002-010-4
!Site Plan Name:
!Project Name: Williams
Residential X
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK:
Supply and install 120 gallon underground LP tank with gas line to range and firepit and final connect
CONSTRUCTION INFORMATION:
Additional work to be performedunder this permit — check all that apply:
_Mechanical X Gas Tank )e_ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2369.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jason Williams
Name: Blake Cowdell
Address: 2675 Twin Oaks Tr
Company: Energized Gas
City: Fort Pierce State: _
Address:4252 Bandy Blvd
Zip Code: 34945 Fax:
City: Fort Pierce State :FL
Phone No.7729191333
Zip Code: 34981 Fax: 7723186672
E-Mail:
Phone No7724661095
Fill in fee simple Title Holder on next page ( if different
E-Mail Energizedgenerators@gmail.com
State or County LicenseFL34747
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Ah
A
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
i DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
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 such
prohibit
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
lin 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,
iaccessory 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF mil. , Luai a
COUNTY OF SI- • Lucie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this . J day of 'Surat, 201g by
this A day of ?uyu. 20AI by
+NOL4 COW&II
__ __ _ _Make, Cowdell
Name of person making statement.
Name of person making statement.
Personally Known )— OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- St
R41CHOLE A!P®T
Ig
ture of Notary Public- St
1. =;PONT
Commission No. Fr910301
_gdglpOMMISSION # FF
ission No. f140031 :•: = '' ' . ��tg
EXPIRES May 04, 2
20
EXPIRES ivley 04,2(2
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