HomeMy WebLinkAboutBuilding Permit Application:OMPLE'IED FOR APPLICATION TO BE ACCEPTED
Permit Number: a.a
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• •_`Ali RECEIVED
Building Permit Applic donF
Planning and Development Services ES 2 ?�
Building and Code Regulation Division TST. Lucie County, Permi 'n8
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
`PROP.OSED'IMPROVEMENNT LOCATION: =- '
Address: IL l,21i
Property Tax ID #:
Site Plan Name:
Project Name: _
a - no 1r) . /')/v-) -
f GONSTRUCTION'INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical Gas Tank Gas Piping Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $%g. q Utilities: —Sewer _Septic
Lot No.
Block No.
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTdF(.."
Name nioel
Name: Larry Licastri
Addres • e/% 0.
Company:AmeriGas
City: State: IOU
Zip Code: Fax:
Phone No.
Address:3301 Oleander Avenue
City: Fort Pierce State:FL
Zip Code: 34982 Fax: 772-465-8448
Phone No 7a — �79g -
E-Mail t j rI S4en- Fb
State or County License02707/28579
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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.
:''m
SUPPLEMENTAL-CONSTRLICT1
ON, LIEN LAW=INFORMATIO.N,. .: w?ti„
„ & , •n4. a ;.
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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
WA NER: Y r failure to Record a Notice of Co It in your paying twice for
I proveme to your prop rty. A Notice of Commen ' ent must a ecorded nd posted on the jobsite
b fore the fi inspection. I you intend to obtain Tina cing, consult it lender o an attorney before
ina vnnr Aln}iPP of ('nmmP Pmion}_
I ture of Ow Lessee/Contractor as Agent for Owner
Ignature of C nt ctor icense Holder
STA OF FLO IDA
S� �C>�
S TE OFF ORIDA
CO TY L1�1P
COU OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thiQ day of 2a6by
thiliD�day of C ti .20Qbby
1
Name of pers n making statement
Name of s n making statement
Personally Known OR Produced Identification
Personally Known 6 OR Produced Identification
Type of Identificatiof
*
q
Type of Identification
yr n Notary Public State of Florida
Produced o Boore
a>
Produced ' o_Fx of iota, ubllc Statoof Fk.:i..,
My Commission GG 190e09
Expires=7,2022
Angela M Boore
_ r My Commission GG 19050F
�' Expires 02127.12022
(Signature of Notary Public -State of Florida-)
(Signature of Notary Public-tottg lorida )
Commission No.C--6n 1�1��0� (Seal)
1Of
Commission NoQ-C--.\�w-�-1 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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