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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: \ . )A - ( -1 SCANNED Permit Number: O - ©- Sq BY © .St. Lucie Countv RECEIVED - - Building Permit Applicatio JUL 2 4 2019 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMITTVPE:Gas Tank and Line _PROP.DSED IMPROVEMENT~LOCATION = - Address: 10240 Carlton RD Property Tax ID q: 4210-223-0001-000-9 Site Plan Name: Ciufo Project Name: Cuifo tank and line Lot No. Block No. 'DETAILED~DESCRIPTIONOF WORK; Supply and install 120 gallon LP tank underground with gas line to stub up and capped off in kitchen CONSTRUCTION: INFORMATION::, Additional work to be performed under this permit —check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 1,600.00 _ Sprinklers _ Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: -Sewer Septic Building Height: ,OWNER/LESSEE_ `` CONTRACTOR:• Name Gerald Ciufo Name: Blake Cowdell Address:448 NW Ravenswood LN Company: Energized Gas City: Port Saint Lucie State: _ Zip Code: 34983 Fax: Phone No. Address:4252 Bandy Blvd City: Fort Pierce State:FI Zip Code: 34981 Fax: 772-318-6672 Phone N0772-466-1095 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 FI34747 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 LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ 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 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." `M,4J .CJI. &KS.iIc &wdi C Signs ure of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF_-9{ • 1,w; a COUNTY OF !&+• Lubi The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this M day of -Ju l y 20_a by this Aa_ day of Tull 20JA by Make COW&I -9IQke Cowden Name of person making statement. Name of person making statement. Personally Known _V OR Produced Identification Personally Known _X_ OR Produced Identification Type of Identification Type of Identification Produced Produced AAAA (Signature o (> ii• "�Jubli I (Signature o u iWj bf I(AkkTE �'.�•;5 • : MY COMMISSION N F 983031 Commission ;• MY COMMISSIOy (I� FEa%3031 } 2 0 Commission ,• EXPIRES May 0JSW ••'�" •�• S 14C71398-0•53 ' 14C71898•�'S7 Fl:tltlalloP .cwn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 277/19