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'II APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` l -
� Date: 6/20/19 Permit Number: jui -04 Q 01
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
dress: 18707 TRANQUILITY BASE LN
Property Tax ID #: 3215-801-0066-000-8
Site Plan Name: CALLEJO
Project Name:
CALLEJO
RECEIVED
Building Permit Application JUN. 211
4 2019
Permitting Department
St. Lucie County
Commercial Residential X
NG NEW UNDERGROUND LINE TO TANKLESS WATER HEATER FROM EXISTING TANK
Lot No.13
Block No. 3
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —kGas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:.
Cost of Construction: $ 1000
NameJoseph Callejo
Address:18707 Tranquility Base LN
City: Port Saint Lucie State:
Zip Code: 34987 Fax: (772)220-1829
Phone No. (772)220-9678
E-Mail: emcintosh@elitegasco.com
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name:Cheyenne Ellison
Company: Elite Gas Contractors
Address:2130 Poma Drive
City: Palm City State. FL
Zip Code: 34990 Fax: (772)220-1829
Phone No(772)220-9678
E-Mail emcintosh@elitegasco.com
State or County License 18361
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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:_
Address:
City:
Zip:
all 9 1
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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.
I
iThe 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 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."
Sign re of ner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF — L r_ n
The forgoing instrum nt was acknowledged before me
this day of 20by
A
Name of son makings tement.
Personally Known OR Produced Identification
Type of Identification
Commission No. �►�" Notary Public $late of Florida
iree N f�di�h
ITMy Commission GG 283399
Expires 12/11/2022
Signa ure Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrume t was acknowledged before me
this � day of 20�6 by
Name of pf;,dson making ytatement.
Personally Known V OR Produced Identification
Type of Identification
Produced
of
,� Notary Public State of Florida
Commission ree N Mclntos(tSeal)
Aa My commission GG 283399
j Expires12/11/2022
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