HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Neve�, 18 N-4-t Permit Number:W-WOI�-
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___ _ _ RECEIVED
Building Permit Application
Planning and Development Services DEC 207016
Building and Code Regulation Division ST, 4uci[x county, Parmlttla9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: ER )CO �� Z
PROPOSED IMPROVEMENT, LOCATION:
Address: 2583 Dyer Rd, Port St. Lucie, FL 34952
Legal Description: St Lucie Gardens 25 36 40 BLK 2S 165 FT of n 1155 fT OF IOT 12 (1.31 SC)
(Map 34/25N) (Or 3998-1793)
Property Tax ID #: 3414-501-1412-350-4 Lot No.
Vte Plan Name: Fultz/Peterson Block No.
Project Name. FultzlPeterson
Setbacks Front 10 Back: 10 Right Side: 10 LeftSide: 10 N
G�� eY FO
DETAILED DESCRIPTION OF WORK:
Install underground 250 gallon LP tank and new gas line to range.
CONSTRUCTION INFORMATION: III
JUILIVIIdI WUIRLV UC
E]HVAC
11 Electric
CIIVIIIICU
UIIUCI
Gas Tank
Plumbing
LIIIDPCIIIIIL—L[ICL.RdII
ZGas
d[Jply.
Piping_Shutters ❑Windows/Doors
Sprinklers 0 Generator 1:1
Roof = Roof pitch
0
Total Sq. Ft of Construction:
Cost of Construction: $ 3329.95
S Ft. of First Floor: _
Utilities:In Sewer E]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ericka Fultz
Name: Gamaliel Portales
Address: 2583 Dyer Rd
Company: Ferrellgas
City: Port St Lucie State: FL
Zip Code: 34952 Fax:
Phone No.
dddress 3232SEDixie Hwy
City:`Stuart State: FL
Zip Code: 34997 Fax: 772-287-3456
Phone No. 772-2874330
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: KimWilkins@ferrellgas.com
State or County License: 30558
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
Name: THOMAS COLLINS
MORTGAGE COMPANY: Not Applicable
Name: G" PoRTALEs
Address: 9519LAURELWOOD CT. FORT PIERCE, FL34951
Address:9519 LAURELWOoo cr.
City: FORTPIERCE' State:
Zip: Phone
City: SMART State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Addrdss:3232 sE DIxIE HM
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
of
as Agent for Owner I Signature
STATE OF FLORIDA STATE OF FLORIDA ^.I.
COUNTYOF ii�(]AAW COUNTY OF- YY1WvI!/h
The fo going instrument was acknowledged before me
this! da of 26b
!Name of persO5,making statement
Personally Known V OR Produced Identification
Type of Identification
Produced
(Signature of Nolta-ryi Ic-State of Florida I
Commission No. R:do3lc5 Fl.:,ii1c�2-y
IOMBERLEYLA
.MYCOMMISSION# EXPIRES: Novembe
The foFgoIn gInst ent w s acknowledged before me
this da of Lk6em Wir- 26J2 b
C Qmo.)it) P0r+&1&5
Name of persga making statement
Personally Known ✓ OR Produced Identification
Type of Identification
Produced
(Signature of Nota ublic- State of Florida I
REVIEWS I CO NTER REEVI W I SUPERVISOR REVIEW REVIEW V EVIEWON
FRONT I ZONING
Rev. 8/2/17
S�ERLEY L WILKINS
My COMMISSION # FF 001
:�E I MANGROVE
REVIEW REVIEW