HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLF INP MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: `t Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division /
2300 Virginia Avenue, Fort Pierce FL 34.982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
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Address:
Property Tax ID #:Q32:z)-- Lot No.
Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit -check all that apply:
Mechanical 0*�`GasTank /as Piping _Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:Sq. Ft. of First Floor:
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Cost of Construction:$ L� )�1 ��"l Utilities: _Sewer _Septic Building Height:
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NameName:Larry Licastri
Address: Company: AmeriGas
City: ° State: Address: 3301 Oleander Avenue
Zip Code: V Fax: City: Fort Pierce State: FL
Phone No. Zip Code: 34982 Fax: 772-465-8448
E-Mail: Phone No —)Q) 4�0s---j�Lv
Fill in fee simple Title Holder on next page ( if different E-Mail `ii��4111•fol4�L�r� e.n�jc`S'C l
from the Owner listed above) State or County License 02707/28579
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.
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Signatu of Own r/ Lessee/Contractor as Agent for Owner
Name:
STATE OF FLORIDA
COUNTY O
Address:
The forgoing instrument was acknowledged before me -
Address:
thii,-14:1 _ day of May 2Q0 by
State:
City:
State: _
City:
Zip: Phone:
Name of person makings tatement
Zip: Phone
Name o person making statement
Personally Known i— OR Produced Identification
Personally Known >_ OR Produced Identification _
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
A
of av Expires 02/27/2022
Name:
(Signature of Notary Public- State of Flori a
Address:
Address:
CommissionN6;Z=I;:�s�EP9 (Seal)
REVIEWS
City:
City:
Zip: Phone:
PLANS
VEGETATION
Zip; Phone:
MANGROVE
REVIEW
CFRONT OUNTER
RENING VIEW W
REVIEW
.,.A,.+k,.,t
rk and inctallatinn as indicated.
OWNER/ CONTRACTOR AFFfUV I 1: Application is hereby nidus Lu U.e 1 = r= P^ - - - ---
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
WARNI TO OWNER: Your failure to Record a Notice of Comore cement may result in your paying twice for
im r sore t ur ert . A Notice of Commencem t mus d and posted on the jobsite
P
F3 Y
befo the fir i s ection. you intend to obtain financin consul SW
lende�or an attorney before
co n
Sign ure of ntractor/License Holder
Signatu of Own r/ Lessee/Contractor as Agent for Owner
STATE OF RIDA
STATE OF FLORIDA
COUNTY O
COUNTY OF
The forgoing instrument was acknowledged before me -
The forgoinginstrument was acknowledged before me
260 by
thii,-14:1 _ day of May 2Q0 by
this.M day ofCCCA,1
�CCment l
Name of person makings tatement
Name o person making statement
Personally Known i— OR Produced Identification
Personally Known >_ OR Produced Identification _
Type Identification >n r�,aary,40
Type of Identification �s/en/e/un
Produced
c i S
Produced ra;wtrmir. Slate lit Florida
r`
$ ir—HeFary-PUDIic State of Florida
Y Angela M Boore
My Commission GG 1906
AngeN "r, il00re
g Hhr Cor X., 1' n GG 190609
Expires OZY
A
of av Expires 02/27/2022
2022
(Signature of Notary Public- State of Flori a
(Signature of Notary Pub ic- State o F on a
Commission Ndz_=Q�l� Iz9i (Seal)
CommissionN6;Z=I;:�s�EP9 (Seal)
REVIEWS
SUPERVISOR
PLANS
VEGETATION
SEA REVIEW LE
MANGROVE
REVIEW
CFRONT OUNTER
RENING VIEW W
REVIEW
REVI W
REVIE
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17