HomeMy WebLinkAboutSUBMITTED PAPERSAll APPLICABLE INFO MUST BE COMPLE i w FOR APPLICATION TO BE ACCEPTED
I
Date: 13 5 SCANNED Permit Number: 1 �C3 4
ti— St. Lucie County
IN
MEWED APR 13 20
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772) 62-1553 Fax: (772) 462-1578 Commercial. Residential
PERMIT APPLICATION FOR: 's o-D P�
Address:
Legal Desc
n:
R
Property Tax ID #: / 1% Z9 — d C,1 J _ D Q Q — Lot No.
Site Plan Name1 Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
Aaaitionai worK to De perrormea unc
Mechanic) I Gas Tank
_ Electric _ Plumbing
Total Sq.eFt of Construction:
Cost ofcorNuuu Icltion: $ /i00 Q
permit — cnecK a
�as Piping
_ Sprinklers
Sq. Ft.
Utilities: F
apply:
_ Shutters
Generator
f First Floor: _
?.wer, Septic
Windows/Doors.
Roof
Building Height:
Name. i labs Name:
Address: .) C�.., s :=- b,\_cve_ 6/`. Z a Company: '� . ViA► `
City: f=�� '��•. Stater Address: / fs,,,.�g,
Zip Code: Fax- City: ��. t 2T � .y ; •,�
Phone No. ? Zip Code: 3 x:
k, E-Mail: Phone No%% % I\l
i) 1 436 -] 3
i
Fill in fee simp�e Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License el
State:
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
S,UPPLf'NTAL CONSTI•UCTI'®N LIB LA11V IN®R
/�i`'ON:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ 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 jobsite
before the first inspection. If you intend btain financing, consult with lender or an attorney befo
commencing worJ(or recording your Wtiee of Commencement. 100l'
S o / Le a/Contractor
Si ure of Contractor/License Holde
STATE OF FLORIDA
COUNTY OF_ -9 N .L`1c
STATE OF FLORIQA
COUNTY OF 5 .
The forgoing instrument was acknowledged before me
this k3 day of _ C1+��`� \ 20� by
The for oing instrument was acknowledged before me
this day of 4 P��1 20 6 by
Or, -C:sA-d6\0,kc IC)1\Y\5av\
�,�r•c:s�o.�1n�r �d1�-ns0y1
(Name of person acknowledging
(Name of person ac nowledging )
(Signature of Notary Pu ic- State of Florida)
�a
(Signature of Notary Pub ic- State of Florida )
Personally Known %d OR Produced I a nti
Personally Known N OR Produced Ide iaj
Type of Identification egO��A
Produced?a+Q����o
Typ&of Identification
Ffoduced
Commission No. �L�S�� e�k�`'a.��
Commission No.EE�S�1
C, goo
title ��pGo��r`oJor
1
'♦ O� 0G
= c �� O�
,
REVIEWS
FRON
f;
SUPERVISOR
PLANS
VEGETATIO T
MANGROVE
COUNTER
%
REVIEW
REVIEW
REVIEW
;,";,"REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
EIPARD OF
COUNTY
C IMMISSJOKERS
GAS PIPING SCHEMATIC
.. .... . ..... ...
[L41 E8-1
r
I -
SIZE
[L2]. fL10]
,[Al] .[A-3]
TANK SIZE: GALS.
APPI lr.Ahl(--F - TYPF/.c;17F
Al
A2
A3
A4
K5
A6
[AS]
0, D " 3 BTU
BTU
BTU
BTU
BTU
BTU
113
PIPING
LENGTH & SIZE
Lf
INCH DIA.
(PIPE SIZE WAS TAKEN FROM
THE 2010 FBC FUEL GAS CODE -
Ll
.L2
-FT.
INCH DIA.
TABLE 402 LLi.�Vllj
L3
-FT.
-FT.
INCH DIA.
L4
L5
FT.
FT.
INCH DIA.
'INCH DIA.
B. ST- ���
C%�R&KUM
L6
FT.
INCH DIA.
-DIVlSioly
REVIEWED FOR C CE `11 1`0:T
L7
F.T.
INC.H.DIA.
REVIEwE BY
L8
FT.
INCH DIA.
DATE
L9
FT.
INCH DIA.
MUST RC
PLANS E . vcrpr nn
r
MUSTBEREProNjOB
OR NO INSPECTION WILL ]gE MADE.
�10
FT.
INCH DIA.
Lll
FT.
INCH DIA.
L12
FT.
INCH DIA.
CHPJSDZA,DDVSKY,District No. I -TOD MOWERY, District No. 2 - PAULA A. LEWIS, District No. 3 -FRANNIE HUTCHINSON, District No. 4 -KIM JOHNSON, District No. 5
County Administrator— Faye W. Outlaw, MPA, lCMA-CM VVebske:www.stlucieco.qov
2300 Virginia Avenue - Fort Pierce, FL 34982-5652
Phone (772) 462-2822 FAX (772) 462-1581
/ "/� 11
I"
I �-mil a 10� P
0
JJ
BOARD OF
COUNTY
MISSION.ERS
GAS PIPING SCHEMATIC
- -- - - - - --[AAA]
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.. .. ._T ..... .. eei w7 r ._ r�7 Cc
@ vfY.k.._ [LI" ...�L8]..... ..[-L5J _ EI
SfzE _
.[Al] [A3]
TANK SIZE:
Al _
A2 _
A3
A4 _
A5 _
.A6
GALS.
SIZE
L-91 . [L11
0]
[A5
1p11%6C0 BTU
lon, BTU
BTU
BTU
BTU
PIPING
LENGTH & SIZE
(PIPE SIZE WAS TAKEN FROM
L 1
AFT.
J '� INCH DIA. THE 2010 FBC FUEL GAS CODE -
L2
FT.
.S INCH DIA. TABLE 402 O
L3
FT.
I.NCH DIA.
L4
FT.
INCH DIA.
315
FT.
INCH DIA.
L6
FT.
INCH DIA.
1_7
FT.
INCH DIA.
L8
FT.
INCH DIA.
L9
FT.
INCH DIA.
L10
FT.
INCH DIA.
L11
FT.
INCH DIA.
L12
FT.
INCH DIA.
CHRIS DZADOVSKY, Dis
'ct No. 1 • TOD MOWERY, District No. 2 • PAULA A. LEWIS, District No. 3 • FRANNIE HUTCHIN�TSON, District No. 4 • KIM JOHNSON, District No. 5
County Administrator— Faye W. Outlaw, MPA, ICMA-CM Website: www.stlucieco.00v
2300 Virginia Avenue - Fort Pierce, FL 34982-5652
Phone (772) 462-2822 FAX (772) 462-1581
000