HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO IYUST BE COMPLLWD FOR APPLICATION TO BE ACCEPTED
Date: _ 11 Permit Number:
SCANNED RECEIVED
COUNTY Sf. LUCB COU JUL J 2U19
Building Permit Application permitting DePe1tment
Planning and Development Services
St. Lucie County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMITTYPEIP Tank
PROPOSED IM - ObEMENT LOCATION
Address: 3111 S 21st St, Fort Pierce, FL, 34982
PropertyTax ID #: 2428-602-0033-000-8
Site Plan Name:
Project Name: HAUKE
and install 500 gallon underground LP tank with gas line to generator and final connect
Additional work to be performed under this permit —check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $Z o Vy XIO
—Gas Piping
Sprinklers
_ Shutters
_ Generator
Sq. Ft. of First Floor: _
Lot No.8 & 9
Block No. 2
—Windows/Doors
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE " ` ' '
CONTRACTOR V Y
Namedames Hauke
Name: Blake Cowdell
Address:3111 S 21st ST
Company: Energized Gas
City: Fort Pierce State:
Zip Code: 34981 Fax:
Phone No.7724616777
Address:4252 Bandy Blvd
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 7723186672
Phone N07724661095
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 LicenseFL34747
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.
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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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Signature of Owner/ Lessee Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF n6 • 1,uG12
COUNTY OF Sl—. Lvc i e
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this — day of ��,IM 20_ft by
this a• dayof-ruly 2019 by
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RICLk0. lcowcle 11
Name of person making statement.
Name of person making statement.
Personally Known _� OR Produced Identification
Personally Known K OR Produced Identification
Type of Identification
Type of Identification
Producedj�
Produced
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(Signatu f IAYi�iS2M QJP
(Signature of Notary Public- State of Florida )
., a• EXPIRES May 04, 2020
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