HomeMy WebLinkAbout5407 Citrus Avenue Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Planning and Development5ervices
Building and Code Regulation Division
2300 Vlrglnla Avenue, Fort Pierce FL 3498Z
Phone: (*2) 40.1553 Fax: (772) 462-1578
Building Permit Application
Commercial Residential
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Additional work to be performed under.this permit — check all that qpplyi
—mechanical XGasTank Gas Piping Shutters —Windows/Doors
Generator s•
of •Floor:
•` • •ply} —Sewer _ightt
'Cost of Construction: s
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Name: Larry L�Icaatrl
• 17
Company: AmerlGas
Address-3301 Oleander Avenue
City. f�2r)i- �lwtt_ State: jLi,
49 I ,
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Phone No, r
Fill in fee imple Title Holder on neict page if different
from the owner listed above)
State or Count,, License 02707/2..8579
if value of i�nstrulction Is 11 • •' e pOtice of Commencement Is required.
If value of KVAC is •4 or more, a RECORDED
OESIGNE. ENGINEER: —NotApplicable
MORTGAGECOMPANY: _NotApplfcabie
Name!
Name:
Address:
Address:
City; Stale:
City: , States
Zip: i Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applitble
BONpING COMPANY: _Not Applicable
Name;
Name:
Address:
Address:
city:
Zip: Phone•
Cam:
ZIP: Phone:
OWNER/ CONTRACTOR AFFtDVIT: Application is hereby made to obtain a permit to do the work and installation as Indicated.
I certifythat no work or Installation has commenced prior to the Issuance of a permit.
St. ucie'County makes no repr entation that Is granting a ermlt will authorize the permft holder to build the subject
icable Home owners As ocpation rules, bylaws r and covenants that may restrict or pro lbit such
which is lncohflict with aryl app
Please consultw t Home Owners.Assoctation and review your �sed for any restrictions which may apply,
structure. your
In tion of the of this in all the worts
that I nty
I do nd St.
Lucie Couree
In accordaecevvRh the approved plans, the Floridauested Building Codes aAmendments.
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 Comtiteneern result In your paying twice for
and on the jobsite
impproV nts roparty. A Notice of Commence t m e recor posted
befo !the s inspect if you intend to obtain financi constr t ith lender r an attorney before
rrcin w ca in ur-Notice-of`Commene mt.- — ---
Signatu a of O .r essee/Contractor as Agent for Owner S natureof Co ractor/Llcense Holder
STATED RIDA ST
VIAV COUNTY OF
COUNTY OF 1� . l fT^^
The fo; otng instru ent was acknowled ppefore me The for clog instru ent was acknowlleed�gerj i?efore me
thisZdayof_ 20\by this day of _ Z(Jd_1bY
l'� ,,>�, t, t c b �-�i �y✓� j� L.c Oil l_
- Name of person aking statement Name of person m3leing statement
✓ OR Produced identification
Personally Known .OR Produced identification— Personally Known
Type of Identification
Type of Identification
Produced ced.
;nature
(Signature of N t R/ Pub(ic• state of Florida 1 otary P blic-state of Florida)
Comm, o`"V'oU K'RISTIF ;15BY commis
;� ubljo-sState of Florida „ KRIS KIRBY
= a Commission # GG 925370 1,nYo a,,
% • Corn mission,Expires `h', Notary Public -State of Florida W
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PLANS
fiATllp
"s �3r
sM GROVE
COUNTER
REVIEW
REVIEW
REVIE
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DATE
RECEIVED
DATE
COMPLETED
Rev, 8/,2/17