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HomeMy WebLinkAboutBuilding Permit Application i ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED aa�� j Date: Permit Number: ��®mil •©sp RECEP Building Permit Application FEES 2 4 ZLIId Planning and Development Services Building and Code Regulation Division PERM i-i Et•._. 2300 Virginia Avenue,Fort Pierce FL 34982 St. Lurie Counhi. FL Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential—� PERMIT APPLICATION FOR: Fuel -PROP PSED LMPRQVEMENT LOCATION = _ Address: 90Z y K r r, Legal Description: Art 11a Property Tax ID#: 33Z 7 70.r— •0617— 000'1 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back:- Right Side: Left Side: DETAILED DESCRIP-TION'OF WORK soot 1/19�16 Pe&PeWAe_ . «n s•,;J&_ ..&a CONSTRUCTION INFORMATION _ Additional work to be pe rme under this permit—c ec a flapp y: 1]HVAC _Gas Tank Gas Piping _Shutters Q Windows/Doors 1-1 Electric 0 Plumbing Sprinklers 0 Generator D Roof Total Sq.Ft of Construction: S .Ft.of First Floor: �o Cost of Construction:$ 2.2 Se), Utilities: _Sewer Septic Building Height: OWNER/LESSEE CONTRACTOR Name /1 P EGG!c SAmoo," Name: Lary Licastri Address: TQz& &:a&,.4 7--eei Company: Amengas City: O<� SPA G z" State:_ Address: 3301 Oleander Ave Zip Code: 3 Y? Fax: City: Fort Pierce State:FL Phone No. 71°L 't/lS 71CU Zip Code: 34982 Fax: 772465-8448 E-Mail: Phone No. 772-633-0740 Fill in fee simple Title Holder on next page(if different E-Mail: Brian.Pearl@amerigas.com from the Owner listed above) State or County License: 02707/28579 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 4'iy,]���A'� b' R"' F$- 1t"` $ {"ice• ��''t�13'.�� ����::,`� ic��}�i�w DESIGNER/ENGINEER: Not.Applicable MORTGAGE COMPANY: ,Not Applicable Name: Name: Address: Address: State: City: State: City: I Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: j 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. i 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 im ments to your property.A Notice of Commencement must be recorded and posted on the jobsite fore t fir ection. If you intend to obtain finan ' ;c suit i lender or an attorney before dommenoinaAwk bkr-mcmding Your Notice of Commen m nt Signatur of Agent/Lessee a ure o ntractor/License Holder i STATE O RIDA STATE FLORIDA I COUNTY OF COUNTY OF UL6 e- t `The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this aS day of Fe bruark .203a by this.�aL day of F.ebruA,-�=20_11 by I � L0 r L\Cc�S�r; LCJ r U cq-c k-f i (Name of-perso acknowledgin ) (Name of person acknowledging 2C/.4Q— (Signature of Notary Public-State dTfivirlda) (Signature of Notary Public-State o lorida) Personally Known )C 01 enT.X nally Known x OR Type of Identification Produc di`r Type of Identification Produce ER L D.- I 1 N-FF95 145 ; :•: it -1 My COMMISSION R FF9rA 5 Commission No.FJP 145 . ORES February o1.2 mission No_ i °l ly ORES February 01.2 43 0!53 FbndsNotat 5mco.can A07� 0!63 Fldids erv�.cum I j REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.772014