HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
--Date:-1/29/2019 -- - -- Permit Number:
RECEIVED
• !AN302019
Building Permit Applicatiorrorm, ti,ePd ent
Planning and Development Services St. Lucie county
_ Building. and Code. Regulation Division -
2300 Virginia Avenue, Fart Pierce FL 34982 SCANNED
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X RY
St Lucie
eoufffi
PERMIT TYPE:GaS
PROPOSED INPROVEMENT LOCATION:12314 NW HARBOUR RIDGE BLVD,'PALM CITY, FL 34990 -
Address: 12314 NW HARBOUR RIDGE BLVD, PALM CITY, FL 34990
Property Tax ID #: 4426-600-0004-000-0 Lot No. 3
Site Plan Name: GUMM Block No.
Project Name: GUMM
DETAILED DESCRIPTION OF WORK:
INSTALL ABOVEGROUND 57 GALLON LP TANK AND LINE TO RANGE
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Constructions: Sq. Ft. of First Floor:
rCcTs` awn= c[iori:. Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NamE__._ 77-.. (1
Address..-= _! 2 J,i Lk •yicke) x 1 �� P),t o
Name: GAMALIEL PORTALES
Company: FERRELLGAS
City; Paff-I m State: a",
Address: 3232 SE DIXIE HWY
City: STUART State: FL
Zip Code:MC7 Fax:
Phone NG. "
Zip Code: 34997 Fax: 772-287-3456
E-Mail:-KimWilkins@ferrellgas.com
Phone No 772-287-4330
Fill in fee simple Title Holder on next page ( if different
E-Mail KimWilkins@ferrellgas.com
State or County Licens_ cti,dl 0rX
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE. HOLDER: X Not Applicable
Name:
BONDING COMPANY: X Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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
commenOne work or recordine vour Notice of Commencement.
as Agent for Owner
STATE OF FLORIDA STATE OF FLORID/ ,4 (I
COUNTY OF mu-'K t COUNTY OF YY�y �I iill
The rgoing instrument was acknowledge before me
thi day of TO . 201�by
Personally Known _ I
Type of Identification
Commission
Revised 07/15/2014
OR Produced Identification
The f oing instrument was acknowledged before me
this day of 04n D .2,0 by
(Name of person acknowledging)
Nota rV Public- State
Ily Known ' OR Produced Identification
Identification Produced
�'r;'r,'"o, - KIM RL LOLKINS
No. W 1 1111003105
f]��t ;�• ate ERPIRESINovember 28,2021
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