HomeMy WebLinkAboutBURTON-PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date.- d t Permit Number.,
Building Permit Application
Planning and tlevelopmentServlces
9ullding and Code -Regulation Alvlslan
2300 Illrglnla Avenue, Fort Pierce FL 34982
Phone: (772) 462.1.553 Fax: (772) 462-1578 Commercial Residential
PERMITTYFE; �t-rj a'v"� �
Address:. �1}S ) Gi z [Gt U_ \0Y1 b
La Li.(. : 1
Property Tax ID 9: �� l w)� Lot No. `
Site Plan Name: rkVYl DVIftVA C f I Block No.
Project Name- ,i r
Additional work to be perform ci under this permit- check all that apply:
,Mechanical Gas Tank _Gas Piping ,_,-Shutters _Windows/Doors
Electric Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ � , IL Utilities; _Sewer _ Septic Building height:
Dame L L L_.
AddeessN 14 S-�_ 2,-ti
City f I - - State.•
Zip Code-, 1r Fax:
Phone Ito. 1-
E-Mail: +""L _ L f l V1`Gi. tAAS - [
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name.Larry Licastri
Company.. Americas
Address-3301 Oleander Avenue
Cit - State
.....'�
y; Fort Pierce - e; FL
Zip Code. 34982 Fax: 772465-8448
Al ne Na772-633-0740
E-Ma i I AmeriGes�-7262@amerigas.com
State or County Ucense02-707128579
If value of construction is $2SOO or more, a RECORDED Notice of Commencement is required.
it value of KVAC 13 $7,500 or more, a RECORDED Notice of Commencement Is required.
DESIGNER/ENGINEER: — blot Applicable
Name:
Address: ,w
City: „ - State*
Zip: Phone
FEE SIMPLE TITTLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip; Phone:
MORTGAGE COMPANY: _ Not Applic abie
Name:
Address:
City, ____State:
Zip: Phone:
BONDING COMPANY: —Not Applicable
Name:.
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT. Application is hereby made to obtain a Hermit to do the work and Installation as IndicateeL
I certlry that na 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 aryl applicable Name fawners Association rules, bylaws or and covenants that may, rgrict or prohibit such
structure. Please consult w t your Home owners-Assaclation and review your deed for any restrictions +vhi may appiy.
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 bilure to Record a Notice of C
lmpra�ts t�wutQroperty. A Notice of Commencer
befo the s inspectio . If you intend to obtain #inand
of
STATE OFFt
COUNTY OF
ctor as Agent for Owner
result In your playing twice for
or and posted on the jobsite
lender r an attorney before
Inure of CDhirtctor/Llcense Fielder
"AI A I L-44
Vt/V i COUNTY
The forgoing Instru�� ntJwas acknowledged before me
this )-17L day of fs _ 7-61 , by
{dame of peapn making statement
Personally Known OR Produced identification
Type of Identification
(Signature of No : p Mate of N6AW j t K i h b Y
-_ fJot ary mlssion No. L--=aryPuhkc-State of Florida
Cnmmis pol�k GG 925370
o.+ y Commission Expires
+++" October 23, 2023
Cgm
REVIEWS
DATE
Rey.
The fpr69(ng instr nt was acknowledged before me
this ! day of . 262j- by
.#'a
Name of phrson making statement
Personally Known CAR Produced Identification
Type of Identification
Produced
(signatur Data ubllc-State Iorida I
Commissio No" F, I ST E E K(51$as
to v ,I,c-State of Florid
-_ Commission # GG 925370
n'�
'•++++,+t`" Clctatoer 23, 202
CONTER [ REVIEW { S REVIEWOR . REVIEW I REVISAI REVIEW j REVIEW