HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ _
—Date:_ Permit Number: 2
RECEIVED
o
Building Permit Applicatio FEB 0 4 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: Gas RY
PROPOSED INPROVEMENT LOCATION: St Lucia rn,,"4.
Address: 9406 Bunting Lane
Property Tax ID #: 1334-502-0063-000-9
Site Plan Name:
Project Name: Scott
Install 500
Lo 4
Lot No.146 & 147
Block No.
ICRIPTION;OF WORK:_ =
LP tank to generator and final connect 4- Prn�a_ P c 5 ;.,�, 120 Gc.1 k i
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical �GasTank _Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 3795.00
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:`
CONTRACTOR: _
Name Dan & Betty Scott
Name: Blake Cowdell
Address:9406 Bunting Lan
Company: Energized Gas
City: Fort Pierce State: _
Zip Code: 34951 Fax:
Phone No.772-201-1120
Address:4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone N0772-466-1095
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail EnergizedGenerators@gmail.com
State or County License FL34747
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.
.,
-SU.PPLEMENTALCONSTRUCTION, LIEN -LAW INFORMATION: -.-- - -
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 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
commpjncjng work or recording your Notice of Commencement.
Sign3fiuz3f Owner/ Lessee/Contractor as Agent for Owner SignaturecUrConfractor/�Licen1se HoIcTer
STATE OF FLORID-- I COU
,n 4 TNTY OFOR,ST.
COUNTY OF— l .I(
The forgoing instrument was acknowled a efore me The forgoing instrument was acknowled fjl-�before me
this a-`% day of J avi Ua ry 20�by this a 9day of um Uu.1— 20) " by
r y R� Q l I 1 LA ��
Name of person making statement. Name of person making statement.
Personally Known �C_ OR Produ ed Identification Personally Known �OR Produced Identification
Type of IdentificatioT Type of jdQntification / Z-)
n -c- State of F�da I (Sig ature of Notary Public- State of
LYSSA BLACKSHEA� Co °"" ALYSSA BLACKS
dta of Flndd�_ ni0tar PJJ66hC -_
:ommission 8 = = I a- otar
GG 237887 = •E Commission s GG 2
My Commission c,.,.:.__
u Y 12,
2022
Jul 1,
xpnes 11
REVIEWS
R
SUPERVISOR
P
MANGROVE
COUNTER
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
nev. y/Zo/its