HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
April 22 2019
Date: P � Permit Number:
SCANNED
0 «.� St. LucieCounty
Q O
10 �"�('�
RECEIVED
Building Permit Application
APR 23;IN
Planning and Development Services
Buildingand Code Regulation Division
9
Permitting Department
St. Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PERMIT APPLICATION FOR: Gas tank
ORR"
Address: 113 Island Dunes Cv Jesnen Beach FL 34952
Legal Description: Los Tortugas at Hutchinson Island Lot 6
Property Tax ID #: 3534-503-0007-000-2
Lot No.6
Site Plan Name: Ivany
Block No.
Project Name: Ivany
Setbacks Front Back: Right Side: Left Side:
q137 1P _ w
.
Interior & Exterior LP Gas lines and underground tank 500 gallon
TWH-2, Cook,top, Grill, Pool Htr & Gener.
Nutt £ I RI1tAT.r .. W
rt�
i itiona wor to ,fie per orme un er t is permit—c heckn apply.
OHVAC IJ Gas Tank W]Gas Piping _ Shutters
11 Electric 0 Plumbing []Sprinklers Generator
.
t
.,.rP.
❑Windows/Doors
El Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
..
Cost of Construction: $ 6600.00 UtilitiesSewer Septic
Building Height:
ER/ EIS ID' Asp
RA�TOR
"YE�,T�x.(3�`"': tr.'}'iii" '•
Name: Cheyenne Ellison
r
':s' i�'.+.5.�'. '' .....b.
Name Robert Ivany
Address: 8650 S Ocean DR apt. 403
Company: Propane Services Inc DBA Elite Gas
City: Jensen Beach State: FL
Address: 2130 SW Poma Or
City: Palm City
State: FL
Zip Code: 34957 Fax:
Phone No.
Zip Code: 34990
Fax:
E-Mail:
Phone No. 772-220- 9678
Fill in fee simple Title Holder on next page ( if different
E-Mail: info@elitegasco.com
State or County License:
18361
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of commencement is required.
SUPt?I EMGfi1TALQONSTRUCTtOiL'IN lAW IN01iMAT10
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address: 2130 SW Puma or
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 firstjnspection. If you intend to obtain financing, consult with lender or an attorney before
as
STATE OF I
COUNTY O
The fo ing instrum PVT
before me
this day of V � 20a by
C'{><wfzj� GLu sad
Nalrne of persoV making statement
Personally Known OR Produced Identification
Type of Identification
(Sigyl'ature of Notary Public � Flor ohna Glen
Commission No. ;,_CAtISSIONGG248
r EXPIRES: August 13.2
BonREVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
Rev.
Signature of,Qontractor/License Holder
STATE OF FLORIDA ��//✓,z )
COUNTY OF
The f ing instrum as acknowledged before me
this Fdayof,20f_ by
(6w, &E 7f C&U Swi.
Name of pers making statement
Personally Known J OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
ICommissionNo. 1'• ;.�en� Glebe
ISSI N 4 GG24M
�NM 441 FXPIRES- Amust 13. 2022
PLANS REVIEW I VEGETATION I S REVIEW LE I MRE IE`OVE