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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED lam% Date: Z... /% Permit Number: � f � � DEC I 'Ad 2017 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Fuel " ,r,., 'r Address: Z 3 2'95' 061an Qfe _AVC Legal Description: SeC i SS Property Tax ID #: 9-Z� 0iF' ✓1 Z 7,- Q00/ - =- 0 Lot No. Site Plan Name: Block No. Project Name: & /yi" Setbacks Front f0 Back: �_ Right Side: /y Left Side: 0 r a ry I0oo( s'4 FM y\.�f'✓''f, l tO �,' jF 4CONSTRUCTION INFORMATION 4 21 � .,<. Additionalwor to be e orme un er t is permit - c ec WGas all tn ❑ ❑apply: HVAC Tank' 2Gas Piping _ Shutters Windows/Doors Electric 0 Plumbing Sprinklers E Generator 0 Roof Total Sq. Ft of Construction: Cost of Construction: $ 2375. oG S Ft. of First Floor: _ UtilitiesSewer OSeptic Building Height: OWNER%LESSEE `` �� k�rµ art' t G Y e.':n✓. ;CONTRACTOR u` t j k�s �� tiz Name Name: Lary Licastri Address: 2�-t (3,u64,e Az'� Company: Amerigas State: Address: 3301 Oleander Ave City: o.,i>°IL� _ Zip Code: 3 �[� y S Fax: 7 �/6S, 91*Vy' City: Fort Pierce State: FL Zip Code: 34982 Fax: 772-465-8448 Phone No.7- 4 ,Z-Zs7-7W Phone No. 772-633-0740 E-Mail: : Fill in fee simple Title Holder on next page (if different E-Mail: Brian.Pearl@amedgas.com from the Owner listed above) State or County License: 02707/28579 If value of constructionis $2500 or more, a KC6UKUCU P10nce 0f 1=4u T0P --it I i I :�,- ©,Z 2 i !-:L-: uH.y� [�,h ✓%'yT' ` A �iCJ..a'Y +ir ry.L4z• J `'1L�:�4 .I +,P:I� i? 4. ` "^``� Ya �,yct i .In 4� fY}1J! - xCi.J7J1 'it:1 �Y-=Y'� ri �� aP}♦ s�.�7"�1 ��SVJ '�,ry ^ya1 } • Y,Y7"ry spy Ott t } µtn jt ; y r��`� 4 l�Yj {r TSr P�ia .kY`�:-� IDESIGNER" aW.....� .f} i_»:i ENGINEER: iVo#�A licable Not Applicable pp MORTGAGE COMPANY: 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 AFFIDVIT: Application is hereby made to obtain a permit to do the work and instailation as indicated. I certify that no 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 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, accessorystructures, 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 E ments to your property. A Notice of Commencement must be recorded and posted on the jobsite re firnspection. If you intend to obtain finan ' , csult�\ lender or an attorney before mran na rk??..r rprnrdine vour Notice of Commenvoment Lessee STATE.&FORIDA STATE OF'FLORIDA COUNTY OF S+. ���� �. COUNTY OF The forgoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of . 20 by this day of 20 by Lw 'caSkri Lmm.'casihn (Name of person acknowledges ) (Name of person ackh6wiedging La (Signature of Notary Public- State Florida) (Signature of Notary Public- State d4lorida ) Personally Known �_ OR Produced Identification Personally Known X OR Produced Identification Type of Identification Produced Type of Identification Produce Y r wtu�si Commission No. REVIEWS COMPLETED FRONT I ZONING COUNTER REVIEW ,�y AMBER L 2104 rN COMMISSION 1! FF EXPIRES Fepniery 01 2020 SUPERVISOR I PLANS REVIEW REVIEW 4WZ*MISSION ii FF956 EXPIRES FWUM 01. 20: VEGETATION I SEATURTLE I MANGROVE REVIEW REVIEW REVIEW