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Home My WebLink AboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO /// MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / Date: 9.09- �`"i Permit Number: SCANNED BY ' St. Lucie County Building Permit Appii ation OCT 9 2019 Planning and Development Services Permitting Department Building and Code Regulation Division Y St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential - xx PERMIT TYPE: LP Gas PROPOSED IMPROVEMENT LOCATION: 5209 Indian Bend Ln, Fort Pierce, FL 34951 Address: 5209 Indian Bend Ln, Fort Pierce, FL 34951 Property Tax ID #: 1312-800-0027-000-2 Site Plan Name: Helen Project Name: Halen Lot No.196 Block No. DETAILED DESCRIPTION OF WORK: • I Install 15' of Ip line from existing underground 250 gallon tank to generator I CONSTRUCTION INFORMATION: I Additional work to be performed under this perr it —check all that apply: _Mechanical _ Gas Tank V Gas Piping _ Shutters -Windows/Doors _ Electric —Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ 1050.85 Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name John Halen Name: Tom Fite Address: 5209 Indian Bend Ln Company: Ferrellgas City: Fort Pierce State: FL- Zip Code: 34951 Fax: Phone No. 860-303-6279 Address: 3232 SE Dixie Hwy City: Stuart State: FL Zip Code: 34997 Fax: 772-287-3456 Phone No 772-287-4330 E-Mail:johnhalen@sbcglobal.net Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail KimWilkins@ferrellgas State or County License 01237 If value of construction Is $2S00 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,S00 or more, a RECORDED Notice of Commencement is required. 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: _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 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 YOUB NOTICE OF COMME EMENT.' Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Martin COUNTY OF Martin The forgoing instru ent was acknowledged before me this�dayof 6 20_4 by The forgoing instrument was acknowledged before me this I() dayof Dttokag r'.20141 by Tom Fite Tom Fite Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Type of Identification Personally Known V OR Produced Identification Type of Identification Produced Produced J/J)baw�- (Signature of Not bI - a ,a,wrvu' KIMBERLEY L. WILKINS Commission No. FF06 tiD P'_ M� (IMISSION#FF063105 • �' E PIRES: November 28, 2021 ignature of N ary Public -St �evPW'•. KIMBERLEY L. WILKINS mmission No. FFO6 % a' `` @ MyO §SION#FF063105 ;.: �•, Y,Y EXPIRES: November 28,2021 REVIEWS FRON PLANS REVIEW VEGETATIO NA�COUNTER REVIEW R LE REVIEW MANGROVE REVIEW ING REVIEW SUPERVISOR REVIEW DATE RECEIVED DATE COMPLETED ev.