HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONY
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3\5� \\ � Permit Number:
Building Permit Application MAR 0 5 2019
Planning and Development Services BT: 6uEIn
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _
PERMITTYPE: Gas SCANNED
PROPOSED IMPROVEMENT LOCATEON '" '' -ri'm
Address: SS33 First I ee Kci
Property Tax ID q: 3334-500-0050-000-5
Site Plan Name:
Project Name:
Install 500 gallon LP tank to generator and final connect
C0IVSTRIJClNFORM&b = .-
Additional work to be pe VasTank
ed under this permit —check all that apply:
Mechanical Gas Piping Shutters
_ Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 3695.00
_ Sprinklers _ Generator
Sq. Ft. of First Floor:
Lot No.39
Block No.
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER%LESSEE:
CONTRACTOR.-
Name Susan Mullen
Name: Blake Cowdell
Address:8833 First Tee Rd
Company: Energized Gas
City: Port Saint Lucie State: _
Zip Code: 34986 Fax:
Phone No.917-841-7329
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 $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL$CONSTRUCTION
LIEN LAW INF,ORMATDO,N
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signs re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF (_ ZZI d
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by
Name of person making statement.
Personally Known Og oduced Identification
Type of�lden^tifica n /
PrOdLL ed / /
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Signor/Licen 6�(' 4�
STATE OF FLORIDAs \ ) ( 1n n p
COUNTY OF (�- �J L i
The oing instrument was
acknowledged
/acknowledC/get-before
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Name of person making statement.
Known )`� OR Prgdu4ed Identification
Type of
Commission No.
Public- State of Florida
(Seal)
REVIEWS
FRONT
COUNTER
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REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
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',;ra o°,c My Commission Expires ';. a` My Commission Expires
July 12. 2022 July 12, 2022