HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE I IFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: . v Permit Number: 5
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St. LucieCounty
Building Permit Application
Planning and bevel p'mentservices JUL 2 4 2019
Building and Code Regulation Division ST. Lucie County, Perrr
2300 Virginia Avenue, Fort Pierce FL 34982 - h'� —
Phone: (772) 462-1553 Fax: (772) 462-1578_ _ _ commercial Resident12Ix
PERMITTYPEIP Tank
PROP..OSED IMPROVEMENT LOCATION 7
Address: 12318 NW HARBOUR RIDGE BLVD, PALM CITY, FL, 34990
Property Tax ID #: 4426-600-0005-000-7
Site Plan Name:
Project Name:
Supply and install 500 gallon underground LP tank with gas line to generator and final connect
Lot No.4
Block No.
CONSTRUCTION INF(DRMATION
:
Additional work to be performed under this permit— check all that apply:
_Mechanical —Gas Tank —Gas Piping —Shutters —Windows/Doors
—Electric —Plumbing —Sprinklers —Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3995.00 Utilities: Sewer Septic Building Height:
,A — —
OWNER/LESSEE
CONTRACTOR —'
NameAdelaide Coy 7,
Name: Blake Cowdell
P- •, i
Address:2740 SW Martin Downs BLVD #.2$1.' ; ' :
Company: Energized Gas
City: Palm City State: —
Zip Code: 34990 Fax:
Phone No.
Address:4252 Bandy Blvd
City: Ft 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.
-SUPPLEMENTAL CONSTRUCTION' ,04, LAW, INFORMA TI,ON:`
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City: --
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City: - - - -
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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Sig re of Owner/ Lessee/Contractor as Agent for Owner
Signaiu a of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF W- Lutie-
COUNTY OF s�. Luzie
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this-/Edayof 70Iy ,20A by
this) 'dayof Tuly .20/9 by
Vake, CowAeLL
Make ifDLA MI
Name of person making statement.
Name of person making statement.
Personally Known )— OR Produced Identification
Type of Identification
Personally Known .—OR Produced Identification
Type of Identification
Produced
kLikJA, QD ptit
Produced
(Signature of Notary Public- late of Florida I
(Signature of N
Public-
Commission No (
H®LE P�NTE
Commission No
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X. HICHOLE APONTE
MY COMMISSION # FF963031
�MMISSIC094963031
EXPIRES May 04, 2020
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