HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
SGANNE®
BY
St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE:Gas Tank and lines
PAQPOSEDIIVIPROV"PA NTLOCATION #a''
Ta
Address: 333 Baysinger Ave
Property Tax ID #: 3403-501-0219-000-2
Site Plan Name: O'Carroll
Project Name: O'Carroll
Lot No.
Block No.
DETAILED DESCRIPTION°OF WORK TV
Supply and install 500 gallon LP tank with gas Pone to tankless water heater fireplace bbq and final connect
Additional work to be performed under this permit— check all that apply:
Mechanical 2KGas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
cN
Cost of Construction: $ H19 S
Windows/Doors
Roof Pitch
Utilities: _ Sewer _ Septic Building Height:
..
OWNER/LESSEE
:CONTRhCTOR 4 .x
NameTimothy O'Carroll
Name: Blake Cowdell
Address:332 Baysinger AVE2
Company: Energized Gas
City: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No.
Address:1786 SW Biltmore Street
City: Port Saint Lucie State:Fl
Zip Code: 34983 Fax: 772-318-6672
Phone No772-466-1095
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-LCzRQLI i
If value of construction is 5z5uu or more, a newrtuc.+ ., ^_••• •• •-�_.. __.
if value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPL`EMENTALkCONSTRUCTION LIEN 1,4W INFQRMATION
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
Address:
City:
State: _
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
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 Homeowners 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."
Signat of Owner/ Lessee/Contractor as Agent for Owner I SignaTTre of Contractor/License Holder
STATE OF FLORI A STATE OF FLO QA`
COUNTY OF LA rLi� COUNTY OF i' )C �
The ff ing instrument was acknowledged before me
this day of 20M by
&kVil! CC11X3`ak
Name of person making statement.
Personally Known �_ OR Produced Identification
Type of Identification
Produced
W C,0wIBgI0N # GG
The forgoing instrument was acknowledPedd before me
thiseMA n( MJQr__1( . 201ft by
QkriVe ('_CAj,)J-f k(
Name of person making statement.
Personally Known Y OR Produced Identification
Type of Identification
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