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HomeMy WebLinkAboutHITE-PERMIT APPLICATIONAll APPLICAS INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:._. Building Permit Application - Planning and DevelaprnentServloes But7ding and Code-Reguladon 6ivhfon 2300 Virginia Avenue, Fort Pierce Ft 34M Phone: (772) 462.1553 FaX: (772) 462-1578 Commercial Residential rPERMITTYPE;�'�-Q. Address: Property Tax ID #• 3 r I� i — �� -' - Lot No.,_�_ - Site Plan Name: Block No. Project Name. Am ma Additional work to be performed under this permit —check all that 1pply- _Mechanical . -- as Tank as piping Shutters Windows/moors Electric Piumbing _ sprinklers ; Generator Roof—.Pltch Total 5q. Ft of Construction: Sri. Ft. of First Floor: cost of Construction: $ ,,,,, ,:S!g- � Utilities: _Sewer ,_ _Septic Name �t!(y� U Address 1 } City; v yr + W'u-C, State: Y` Zip Code: Fax: Phone No.� E-Mail: `%in t 14 L'i C � = k 12 17, { UV✓' Fill In fee simples Title Holder on next page ( if different from the owner listed above) Building Height:_ Name. -Larry Licastri Corn pang: AmerlGas Addresst3301 Oleander Avenue city, Fort Pierce State: FL Zip Code: 34982 Fax: 772 465-8448 Phone No772-633-074© E-Mail AmerlGas-7282@arnerigas.corn State or County Ucense027€17f28579 if value of construction is $2SOO or more, a RECORDED NcKiee of Commencement Is required. If value of HVAC is $7,00 ar mora, a RECORDED Nodee of Commenimment is required. Ix- W14 MORTGAGE COMPANY: —NotApplicable DESIGNER/ENGINEER: 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 AFADVIT: Application is hereby made to obtain a permit to do the work and installatloi: as Indicated. I certify that no Mork or Installation has comme=d prior to the Issuance of a permit. St. Lucie County makes no representation that Is granting a permit 111 aut orlie the permit holder to build the subject sf�Ncture. which Is in conflict with anyi ppiicable Home Qwners Ats4cfation rules, by aws or and covenants that may restrict or pro ibit such stnictvre, Please consult w t your dame Qarners 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 FioTida Building Gerdes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrence review: room additions, accessr ry structures, swirriming pools, fences, walks, signs, screen rooms and accessory uses to another non-residential use WARNING TO. OWNER: Your failure to Record a Notice of improv nts t roperty. A Notice of Commeriv befo the s inspect v . If you intend to obtain finan of STATE OFFt COUNTY OF as Agent V&V The going instrument was acknowledged before me this&-W- day of W &EEl 24�L 1hy ymaLt , i h Sj-V L Name of pe car eking statement Personally Known OR Produced identification Type of Identification (signature of i'rotary Public- state Cgmmissionf+la. a 16 �jTIE KIRBY Notary Puu'lic-State of Florid Commission # GG 925370 f. Cninmi5sion Expires REVIEWS COUNTER I REVIEW I REVIEW I DATE COMPLETED Rev. 8/2/17 resuit In your paying twice for :or and posted on the)obsite lender ran attorney before of Cohiractor/Licanse Hoider COONSTATEQEF.I ORI 041 l (tAn �!V�/✓ CQIiiVTY OF i ►' The rgeing Irtstr entwas a kncswled afore me this day of . � aD by Name of ph;wfii making statement Personally Known OR Produced Identification Type of Identification PLAINS REVIEW Notary Public- State of Florida I �1STIE. K{5011 dory Public -State of Florid Commission # GG 925370 nctnhar 23. 20"3 REVIEW I REVIEW