HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/16/19 Permit Number:
ANNED
61 BY
glQiWh gftt Application RECEIVED
Planning and Development Services JUL Vb\2019
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 permitting Department
ty
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Xt• ��cie Coun
PERMIT TYPE:GAS
Address: 7921 PLANTATION LAKES DR
Property Tax ID #: 3321-801-0060-000-2
Site Plan Name: PATRICK
Project Name: PATRICK
INSTALL NEW GAS LINE FROM EXISTING LP TANK TO NEW POOL HEATER
Lot No.60
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank JGasPiping_Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction: -
Cost of Construction: $ 1000
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
IN TR "
NameJames C Patrick Karen L Patrick
Name:Cheyenne Ellison
Address:921 Plantation Lakes DR
Company:Elite Gas Contractors
City: Port St Lucie, State: _
Zip Code: 34986 Fax:(772)220-1829
Phone No. (772)220-9678
Address:2130 Poma Drive
City: Palm City State: FL
Zip Code: 34990 Fax: (772)220-1829
Phone No(772)220-9678
E-Mail:emcintosh@elitegasco.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailemcintosh@elkegasco.com
State or County License 18361
It 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.
SUPRt -ME{V !A( CE3 STR
ON IN LA' t
FO TIQ,
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: Applicable
Name:
_Not
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 REEDRDINC YOUR NOTI[E OF GOMMFN[EMFNi_"
� ��
Slg�re Owner/ Lessee/Contractor as Agent for Owner Signatur of on ctor/License Holder
STATE OF FLORID/CC//w �I STATE OF FLORIDA
G
COUNTY OF COUNTY OF ?Ka —mil' v-
The forgoing instrument was acknowledged before me
this 40—dayof C I (A�201—q by
Name of pembn making s tement.
Personally Known OR Produced Identification
Type of Identification
�Nqgtery Pub
tl State of Florio,
Commission No. cintosh
hMNr Commission GG 283399
aw ExPires 12r11=22
REVIEWS I FRONT COUNTER I ZONING
EVI W S REVIEW
The f rgoing instrument as acknowledged before me
this/�i�. day of (I((A ILA2�/0L� by
Name of pers6h making tement.
Personally Known NOR Produced Identification
Type of Identification
Commission Nd,.7L!5�o(d-5 ublicStale of
61Ne N McIntosh
PLANS I RE VIEW VEGETATION EVI WI S REV EWLE IREVIEW