HomeMy WebLinkAboutBUILDING PERMIT APPLICATION (2)Ali APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `\ N. \.N1N� SCANNED Permit Number:BY
RIF
s' ' St. Luce County RECEIVED
-- — - Building Permit Application N0V 1 9 "Dig
Planning and Development Services ST, Lucie County, Permitting
Building and Code Regulation Division -
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1S78 Commercial Residential
PERMIT TYPE: GAS
PROPOSED IMPROVEMENT LOCATION:
Address: 15343 WALDO PEPPER DR
Property Tax ID It: 4224-501-0035-000-2
Site Plan Name: MURPHY
Project Name: MURPHY
DETAILED DESCRIPTION OF WORK:
EXTERIOR LP GAS TANK AND LINES TO POOL HEATER
CONSTRUCTION INFORMATION:
Lot No.35
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical O9(Gas Tank AGas Piping _Shutters _Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 2400
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
NameJames G Murphy
Name: Cheyenne Ellison
Address:15343 Waldo Pepper DR
Company: Elite Gas Contractors
City: Port Saint Lucie State: _
Zip Code: 34987 Fax:
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@elitegasco.com
State or County License 18361 lia5sb
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 TITLEHOLDER: _ 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."
Si re of ner/ essee Contractor as Agent for Owner
Si at of tractor/License Holder
STATE OF FLORIDA
STATE OF FL0
COUNTY OF /'jojhm
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COUNTY OF /YD1 ✓f7 N
The forgoing instru nt was acknowledged before me
this, -day by
The for oing instru t was acknowledged before me
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Name o rson making statement.
Name of lWrson makings tement.
Personally Known t/OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
inaledrroff4otary Public
(Signatufe 6TNIotary7ubli
Notyaryr�Public State of Florid
M. Notary Public State of Florida
Commission No.GG1 �6Ce e N McIntosh
y mmission GG 283399
ission No..oeftll)l McIntosh
p
01, Expires 12/11/2022
y . My omrtussion GG 283399
+q�^di''
Expires 121112022
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Rev.2/7/3.9