HomeMy WebLinkAboutCRUZ-PERMIT APPLICATIONAll APPLICABLE INFO `MUST BE COMPLETED FOR APPLICATIGN TO BE ACCEPTED
Date:,
,- �1) i Permit Number:
r Building Permit Application
Planning and Development Services
Building and Code Regulation Divbslon
2300 Krginla Avenue, Fart Pierre FL 34M �,-
Phone: (772) 462.1553 Fax- (77z) 462-1578 Commercial Residential
I PERMIT TI' IE: vlhf luvq
Address:.
Property Tax ID #: Q �_P — D Lot No. _•- EE�
Site Plan flame: t C VLA Block No.
Project Name: in I✓ VIA Z
Additional work to be performed under this permit— check all that apply-
-Mechanical ,,,•'asTarrk -lasPipirtg _ShuttersWindows/Doors
_ Electric Plumbing _ Sprinklers _ Generator _ hoof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
'Cost of Construction:$ Utilities: —Sewer —Septic Building Height:
Nam
city: state',
Zip Code: Y k Fax:
Phone No. 1 .-P I is 3—. 7 11 Ll
Fill in fee simple Title Holder on next page ( it different
from the Owner listed above)
Name•Larry Licastri
Company:AmeriGas
Address:s3a1 Oleander Avenue I
City: Fort Fierce Slate FL i
Zip Code: 34982 Fax: 772-�5-8448
Phone ND772 63M740
E.MailAm;ariGes-7262@amedgae.com
State or County UcenseC2707128579
it value of construction is $2SOO or more, a RECORDED Notice of Commencement Is required.
H value of KVAC is $7,500 or more, a RECORDED Nodee of Commencement is required.
ENGINEER: _ Not Applicable
Name:
Address:
City: State.
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City.
Zip' Phone:
MORTGAGE COMPANY: Nat App€kable
Name;
Address: ,
City: State:
ZIP: Phone: ..
BONDING COMPANY: __Not Applicable
Name:
Address:
City:
Zip:_ Phone,
OWNER/ GONTRAC;OR AFFIDVIT: Application is hereby made to obtain a permit to do the work and €nAallatlon as Indicated.
I certify that no work or Installation has commenced prior to the Issuance of a permit.
Sf= Lucie Coun�r makes no representation tha is gran ng a Aermlt will authorize the permit holder to build the subject structure
which is In conflict with any ppllcable home nersksotiadon rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult wlt�i your Horne Owners.Association and review your deed for any restrictions whit 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 Ronda Building Codes and St. Lucie County Amendments.
The fallowing building permit applications are exempt from undergoing it full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessary uses to another rion-residential use
WARNING TO. OWNER: Your failure to Record a Notice of
Improroperty. A Notice of Commend
befv the inspect if you intend to obtain #roan
of Owr-rr%Lesaee./Contractor as
COLINSTATE Q OF 7?41(,1M j j wt/Ir
COLIN'EY OF 1
The fi rgoingins entwasacknowledg�lkeForeme
this,C_dayOr L xa by
Name of persoking statement
Personally Known OR Produced identification
Type of Identification
It In your paying twice for
and posted on thejobs€te
pr are attorney before
of CobiractorAlcense Holder
2
The forgoing Instrurnegwas acknowled3 hpfore me
this dayof . t. . 2Q v.._W ,
Name of peaking staterent
Personally Known OR Produced identification
Type of Identification
(Signature of NotaryP ISTIE KIRBY gnatu
o'" aQ 1�4otar(� P�IiC-State of Flori a
Commission No. _r _ Cortiml�Sion # GG 92537 mmis�
' : My Commission Expires
October 23. 2023
REVIEWS FROM' 20NI W SUPERVISOR PLANS
COUNTER REVii:Vlf REVIEW I REVIEW
' DATE
COMP
Rev.B/Z
fNotaryPublic- t�prY q`da] KRISTIE KIRK
Notary Public -State of
(5601jnission # GG 9
My Commission Ex
October 23, M
VEGETATION f SEA TURTLE ! MANGROVE
REVIEW ! REVIEW REVIEW