HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q /�7,�1 �t
Date: Permit Number: _� f OL- Ej�-�o` I
L I —q REceiveo
g 10%
r Building Permit Application FEe 9 epartment
w
Planning and Development Services perefit�nle C0130tl
Building -and -Code -Regulation Division St.
2300 Virginia Avenue, Fort Pierce FL 34982 -
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: Gas SCANNED
PROPOSED INPROVEMENT LOCATION: q BY
•____ 19004 MIA/LJ�rhniir Ririne Rh,,! J
Property Tax ID q: 4426-815-0009-000-5
Site Plan Name:
Project Name:
Install 500 gallon LP tank to
and final connect
:CONST;RUCTION:INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2995.00 Utilities: _ Sewer _ Septic
Lot No.
Block No.
—Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:= =
CONTRACTOR:
Name Dennis &Gail Garda
Name: Blake Cowdell
Address:12901 NW Harbour Ridge Blvd
Company: Energized Gas
City: Palm City State: _
Zip Code: 34990 Fax:
Phone No.772-359-9610
Address:4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 772-318-6672
Phone No772-466-1095
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
it 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: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
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 con, 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
commencing work or recording our Notice of Commencement.
ec
(
Q(%'
Sign a of Owner/ Les ontractor as Agent for Owner
Sig re of Contractor/License Holder
STATE OF FLORID Ac� ] �t /�
STATE OF FLORID
COUNTY OF ( (_�C ,
COUNTY OF f I
The f rgoing ins m nt was acknowledg d efore me
thisdayo 20� y
The f rgoing insLcum ht was acknowledged before me
this�dayot� 0 y
Name of person ma Ing statement.
Name of person makin statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type o 1 entification
Type of Identification
Prod ced
Produc
(Signature of Notary Public- State of Florida)
(Signatur of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLET
ALY
SA BLACKSHE
R
ev.
• ",
¢i�+''s State of Floride•Notery Public
n •e Commission # GG 237887
My Commission Expires
July 12, 2022
c
y a Commission # GG 237887
'moo?�m.�o��,.� My Commission Expires
July 12. 2022