HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/14/2019
C,r/t NED Permit Number:BY
St, Lucie CODW ✓11Af b
4
Building Permit Application psr,�f'�yo ?Ojg
lanning and Development Servicesuilding and Code -Regulation Division- - - `c'P CO B0t eo?`
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XX
PERMIT TYPE: RESIDENTIAL
PROPOSED IMPROVEMENT LOCATION:2719 PLACID AVE, FORT PIERCE; FL 34982"
Address: 2719 PLACID AVE., FORT PIERCE, FL 34982
Property Tax ID #: 242160600060001 Lot No.
Site Plan Name:
Project Name: CHAVEZ/2009
DETAILED DESCRIPTION OF WORK:
SET 120V ABOVEGROUND LP TANK AND LINE TO RANGE AND FURTURE WATER HEATER
CONSTRUCTION
Additional work to be performed under this permit- check all that apply:
_Mechanical ""'Gas Tank /GasPiping _Shutters
_ Electric —Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1232.00
_ Sprinklers _ Generator
Sq. Ft. of First Floor: -
Utilities: _Sewer _Septic
Block No.
Windows/Doors
_ Roof Pitch
Building Height:
O
CONTRACTOR:
to aala9a da T,
Name: Gamaliel Portales
Address:- 3`l Cl �yx aloo RY4-
Company* FERRELLGAS
City: �17�� g `zCOP. State: '1 L
Zip Code: SLtCAak Fax:
Phone No.
Address: 3232 SE DIXIE HWY
City: STUART State: FL
Zip Code: 34997 Fax: 772-287-3456
Phone No 772-287-4330 , �irn
E-Mail: -
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail KimUUilkins@ferrellgas.com
State or County Licensee 30Lka2_
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.
1-1fJ (0 -
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SUPPLEMENTAL CONSTRUCTION LIEN, LAW INFORMATION
DESIGNERANGINEER:
Name:
Address:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
-FEE-SIMPLE-TITLE-HOLDER:—Not
Name:
Applica ble
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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."
signaturebOwner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MPATIN
COUNTY OF "RnN
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 14 day of JUNE 20_ by
this 14 day of JUNE . 20— by
GAMALIEL PORTALES
GAMALIEL PORTALES
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Procluced A
Produced
"A -
-^
� i�J
(Signature of Not Public-
ature Gf Notary bile- !) Te,o 7XI a KIM13ERLEY L WILKIN
Ni ou •.. rJMBERLEYLWILKBlS
a6a
'':' °'' _ My COMMISSION#FF 063
Commission No. FF063105 = t(9r3ali0MMISSlON#FF 063
Oio
=�
mission No. FF063106 :eF(}tEB: November28,
!;rP%fty5•
EXPIRES:Novelnber28,20
t
6an&dThMNatWPub19UndW
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
AW1
a
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
-
FEE SIMPLE TITLEHOLDER: _ 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 Count�yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in convict 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of ContractorflIrefse Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIpp�
COUNTY OF I I1&C- n
The forgoing instrument was acknowledged before me
this _day of. 20by
The forgoing instrument was acknowledged,¢efore me
t ' J'"[_dayof 20� by
11air-'e_``
Name of person making statement.
Name of person making sta ment.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public -State of Florida)
(Signature of'Nat
Commission No. (Seal)
. KIMBERLEY L. WILMS
Commission No. - MYCOMMIgSO04FF063105
2�tZ 1?oF oo-a`.• EXPIRES: November 28,2021
L, o
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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