HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONT
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ` SCANNED Permit Number:
r�-� BY RECEIVED
St. Lucie County MAY 01 1019
Permitting Department
Building Permit Application St, Lucia County
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: Gas
PROPOSED IMPROVE-N!ENT.COCATION:°
Address: 8505 Immokolee Rd
Property Tax ID #: 1335-230-0001-000-6
Site Plan Name:
Project Name:
Install 500 gallon LP tank to generator and final connect
Additional work to be perf med under this permit— check all that apply:
17
_Mechanical Gas Tank —Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers —Generator
Sr _
tcti� Sq. Ft. of First Floor:
Tota]ES'q*_
Cost of Construction: $ 3695.00 Utilities: Sewer
Lot No.
Block No.
—Windows/Doors
_ Roof Pitch
_Septic Building Height:
OWNER/LESSEE:'
CONTRACTOR: ==
Name Thomas Osteen
Name: Blake Cowdell
Address:8505 Immokolee Rd
Company: Energized Gas
City: Fort Pierce ::. State: _
Zip Code: 34951 Fax:
Phone N0.772-201-1512
Address:4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-318-6672
Phone N0772466-1095
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 Licen 347
o
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.
SUPPLENIfNTA1 C01t1Sf3UCtON LIfN LAINfiNFORMATION
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 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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Signatur Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License�Holder
STATE OF FLORIDA
STATE OF FLORIDA p
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The fo going instr t as cknowledge efore me
The for oing instr, s cknowled efore me
thi day of 20-9by
this day of 20� by 1
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Name of person ma ing tatement.
Personally Known � o Produced Identification
Name of person making statement.
Personally Known _(E OR Produced Identification
Type d ntifi ion
Type of Identificat n
Pro c
Produ
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
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E Commission # GG 237887
a My Commission Expires
July 12, 2022
commission # GG 237887 I
My Commission Expires
" July 12 2022
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