HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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RECEiVEb
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NOV 0 5 7010
Building Permit Application Permitting De artment
Planning and Development Services St. Lucie County
Building and Code Regulation Division
2300 Virginia lAvenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Gas tank
Address: 12
Legal Descri
S Indian River Dr
on: 7 36 41 N 4 Acres of S 33.25 Acres of Fract Sec 7-Less S 15 FT -
Property Tax Ib #: 3507-323-0002-000-1
Site Plan Name:
I
Project Name:j Divan
Setbacks Front Back:
Right Side: Left Side:
Install 1000 gallon LP tank to generator and water heater
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Lot No.
Block No.
Aaamonal worK to bye jej wormed under tnls permit — cnecK all apply:
�L 1 HVAC I Gas Tank Gas Piping _ Shutters Windows/Doors
❑ Electric I ElPlumbingSprinklers ❑ Generator ❑ Roof Roof pitch
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Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Constri ction: $ 5700.00 Utilities: ❑ Sewer E]Septic Building Height:
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OWNER/LEtSSEE :, : ' '
CON_TRAC OR W g� h NY
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Name Daniel & Alison Divan
Name: Blake Cowdell
Address:7203 S Indian River Dr
Company: Energized Gas
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.772i468-7986
Address: 4252 Bandy Blvd
City: Fort Pierce State:'FL
Zip Code: 34981 Fax: 772-318-6672
Phone No. 772-466-1095
E-Mail: i
Fill in fee simple Title Holder on next page ( if different
from'the Ownier listed above)
E-Mail: Energized Generators@gmail.com
State or County License: FL34747
It value.oT construction is �Z500 or more, a RECORDED Notice of Commencement is required.
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SUPPL"EMENTAL CO,NSTRUGTION LIEN LAW.INFORMATION
DESIGNER/ENGINEER: Not Applicable
Name: Daniel &Alison Divan
MORTGAGE COMPANY: _ Not Applicable
N a m e: Blake cowdell
Ad d ress: 7203 S Indian River Dr
Address: 7203 S Indian River Dr
City: FortPiercel State:
Zip: Phone
City: Fort Pierce State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name: i
BONDING COMPANY: Not Applicable
Name:
Add ress: a25z I 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 nd 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
commenciniziwork or recording vour Notice of Commencement.
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1(�.'Pjdot (AVA
Sig o Owner/ Lessee/Contractor as Agent for Owner Sign a ure of Contractor/License Holder
STATE OF FLORID r
STATE OF FLORID�-�
COUNTY OF ,�r COUNTY OF
The oing instj�u�e• t w s ac of�knowled before me
this �1 day of(Xn./� . 20)It by ..
r ND
:��qls
�o
Name of p r n making statement
Personally Known OR Produced Identificati
Type of dentification
Pr d
�3cD
n o
3 N T
The or oing inst\um�en`t_was acknowledged before me
Zhisidayof(�,E ' cep t'20%.by
Name of pe s n making statement
rsonally Known OR Produced Identification
pe of Identification
(Signature of Notary PuEic- State of Florida)
oN 5'm o
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Signature f Notary Public- State of Florida) PQig
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Com ion No. (Seal)
N'9. v
ommi 'on No. (Seal)
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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
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