HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE CO . D FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
� IZECENED
_ p
OCT 012020
Planning and Development Services BuildingPermit ApplicationPer ittingDepartme
nt
St.Lucie County
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PRQpQ5E1? IN1P} 'C)VE1V[ENT L(1er�T10,
_ _ _..._. .,..,,, . _.�,. .. .
Address: 7.2 46 [s'gui 4e s A�,
Property Tax ID#: 43o 61e/-� 6 `P CACj- " Lot No.
Site Plan Name: ,j T+E/."s �a Y I'-' 1 4--,1 Block No.
Project Name:
D)=T���Ef�► DES��PTIQN QE RK Yak
7'�,k
CQN�TRUCTIQNINFQ,RlVlAT(�3N h - - .. � . � ,
Additional work to be performed under this permit-check all that apply:
_Mechanical XGas Tank AGas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
U Cost of Construction:$ T ,� S G3 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE n: �x,9 n.k ,CQNTRACTOR mm t « '
Name Ale Iq r «ppsA3do pis Name:Larry Licastri
Address: 206 e-eu Company:AmeriGas
City: /C:;J';z 47'c-"ck State:�Z Address:3301 Oleander Avenue
Zip Code:-?y?S-I Fax: City: Fort Pierce State:FL
Phone No. Zip Code: 34982 Fax: 772-465-8448
E-Mail: Phone N0772-633-0740
Fill in fee simple Title Holder on next page (if different E-MailAmeriGas-7262@amerigas.com
from the Owner listed above) State or County License02707/28579
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.
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k El1� h� �Q&NSA = T£N TICS 3
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
inpfevements to your property. A Notice of Co' mmenceT3
-atnust be recorded and posted on the jobsite
b fore t spection. If you intend to obtain financi g, cons with nder or an attorney before
c en
--
Sign ure o ner/Lessee/Contractor as Agent for Owner Ina ture o n ractor/License HoSTATE FLORIDA FLORIDA
COUNTY OF COUNTY OF SV LA. gA-S'
The forgoing instrumen was acknowledged before me The forgoing instrument wa{{acknowledged before me
this50 day of c��Q k r 20. by this day o M1�QS ,2Q=M by
Name of perlson making statement Name of r
Personally Known_ OR Produced Identification Personally Known P dub�A Iti b�Ftorida--
Type of Identification Type of Identification a Angela M Boore
Produced R� ,. . P ce a �y CorrhOisslon GG 1906oe
Notary Public State of Fiorda 02/27l2022
Angela M t3oore >
My Commission GG 180600 ,a
(Signature of Notary a ,r' (Signature of Notary Public-State of Florida)
Commission No -n� 63G (Seal) Commission N (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17