HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED
Date: ?
Build!
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fuel
Address: f g 60
Legal Description:
R APPLICATION TO BE ACCEPTED
I
NNED Permit Number: J '
%t LUPIe CO", tV RECEIVED
i� . Permit Application
. MAR 811118
Permitting Department
St. Lucie County
Commercial Residential
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Lot No. 17
Property Tax ID #:
Block No.
Site Plan Name:
Project Name: M, 1142r I
Back: IL Q RigF Side: /O Left Side:
Setbacks Front_ _
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COI�STRICTION$INFORMAT(QN
itiona wor to e�e orme under this permit —Ic ec all apply:
C�HVAC L� Gas Tank gas Piping _ Shutters Q Windows/Doors
11 Electric Q Plumbing ❑Sprinkle I Generator Roof
Total Sq. Ft of Construction: I S . Ft. of First Floor:
Cost of Construction: $ �Utilities: Sewer 0Septic Building Height:
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UWNER/LESSEE
Name_— V,&4 "I %i .//-e l �
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N RACTOR
Name: Lary Licastri
Company: Amengas
Address: / 9-At73 i?�,,�,�, O-t c .�''
U State: L
Address: 3301 Oleander Ave
Ci ty: ,�, e-,
Zip Code: 3'`/g �% Fax: I
City: Fort Pierce State: FL
2 ? z`I6s 70---/ I
Zip Code: 34982 Fax: 772"465-B448
Phone No.
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Phone No. 772-633-0740
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail: Bdan.Pearl@amedges.com
State or County license: 02707/28579
from the Owner listed above) I
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If value of construction is vsZ5uu or more, a KCI.VKVcv Iwau.c Li • .. y,..., ...
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MORTGAGE COMPANY:
Not Applicable
DESIGNER ENGINEER: _ Not•Applicable
Name:
Name:
Address: I
Address:
State:
City: State:
City:
Zip: .Phone-.
Zip: `Phone:
FEE SIMPLE TITLE HOLDER: ____ Not Ap licable -
BONDING COMPANY:
Not Applicable
Name:
Name:
Address: I
Address:
City: I
City:
Zip: Phone: I
I
Zip: Phone:
OWNER/ CONTRACTOR AFFIDViT: Application is hereby made to obtain a perms ro ao me wom drla IIISIdIIdlIU11 d� 1111JMUM..
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Coun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which Is in co2ict 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 menu to your property. A Notice of Commencement must be recorded and posted on'the jobsite
fore t4 firk"ection. If you intend to obtain finan , c t1suit@-ftk1ender or an attorney before
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Si natur=offtent/ lessee
ure o ntractor/License Holder
STATE A
COUNTY OF S�
-COUNTY
STATE FLORIDA
OF
The forgoing instrument was acknowledged before I
e
The forgoing instrument was acknowledged before me
this 7"1 day of mo rck\ . 20 �B by
thisg�:I_ day of M , 20A by
y L�cos�
�II
(Name of•person acknowledging)
;
. (Name of person acknowledging
(Signature of N u tc- State of Florida)
I
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Personally Known_ OR Produced Identification
Type of identification Prodd&d
Type of identification Produced�"t
iP
ti•
�.. ?` t ?• `^ An e!a Boore
��
,•;� `' Notary Public State of Florida
M Boore
Commission N0�'�C,�Cpv!ssion
Commission No �� My�ssion
GG 190609
o� GG 190609
?o f�oQ Expires 02/27/2022
Or Expires 02/27/2022
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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