HomeMy WebLinkAboutCOSTANZO 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 20 Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Address:
Building Permit Application
Commercial Residential _
Property Tax ID#:�Ua 'SULIQ' WJ`7" ��' Lot No. 3_
Site Plan Name:
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical
-"Gas Tank
rGas Piping
_Shutters
—Windows/Doors
Electric
_ Plumbing
_ Sprinklers
_ Generator
_ Roof Pitch
Total Sq. Ft of Construction:
2 I —n
Cost of Construction:$ 1
. 0@
Nam
Addi
'wl isu f AWC A1W-4
E -Mail
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
State:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Na me: Larry Licastri
Company: AmeriGas
Address:3301 OleanderAvenue-
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772-465-8448
Phone Nob-ia
E -Mail 0tne4' Bas,
State or County License 02707/28579
If value of construction is $2500 or more, a KECUKUhu Notice or wmmencemem n mquu cu.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address:
City:
Zip; Phone:
MORTGAGE COMPANY: _ Not Applicable
Address:
City: State:
Zip; Phone:
BONDING COMPANY: _,Not Applicable
Address:
City:
Zip; Phone:
� :., r..11nYlnn �e indiroTad
OWNER/ CONTRACTOR AFFIDVI I : Application Is nereoy mase w UUL41II G P=I%w w- -- --- -
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie CountyY makes no representation that is granting a permit will authorize the permit holder to build the subject structure
strluctis in ure. with
with applicable
Owners Assoc atlon landrreview your deed for any restrict ons at which may ct apply.lbit such
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
WI{UNEjLZ:
Your y yure to Record a Notice of Commencement alt in your paying twice for
im roveme s t our ro ert A Notice of Commencem mu ere ed and posted on the jobsite
be the fir cti n. If you intend to obtain financi ,consult ith n or an attorney before
co
Sign ture of Co tractor/License Holder
r/ Lessee/Contractor as Agent for Owner
Ig@OORIDA
ST
STAT ORIDA
COUNTY OF
COUNTY OF S� l7 -Q
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 3 day of314nQ 2oa t� by
this -day of� 2020 by
t
Name of person aking statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known_ OR Produced Identification
Type of Identification
Type of Identification
Produced r% Notary Public State of Florida
gels M Boore
Produc blit State of Florida
Angela M Boone
uaY My Commission GG 190609
va Expires 02127/2022
ao
My Commission GG 190609
Expires 02]2712022
(Signature of Notary Public- State Florida )
(Signature of Notary - or a
Commission NoIC_ (Seal)
--oof
Commission Ne w—` (Seal)
REVIEWS
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA
REVIEW TURTLE
MANGROVE
REVIEW
CFRONT
OUNTER
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17