HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 2 ? Permit Number: o�
BY RECE vFo
Y 'n t
' ,t�ucie�®u��' MAR
8 2018
Bull i!ng Permit Application Permitting pepart
Planning and Development Services Lucie count),
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
Address: 30 7,
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: i
Setbacks Front_
Z 7— A121-t 06>0t-
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Back: t Q Right Side: / C2 Left Side: D
pE7`AIkEQ QL'SCt2lP71QN xOP"WORK a he
❑HVAC M Gas Tank dGas I
❑Electric 0 Plumbing 0Sprh
Total Sq. Ft of Construction:
Cost ofConstruction: $ J 1 1% 3• itly
ing L _l Shutters
ors .Generator
S Ft. of First Floor: _
utilities.tSewer Septic
Lot No.
Block No.
Windows/Doors
0 Roof
Building Height: II
Name: Larry Licastri
Name or
Company: Amerigas
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Address: 26 � C'r��± ��r �l
r—o State: G
Address: 3301 Oleander Ave
City: e-
Zip Code:`�4S Fax:
City: Fort Pierce State; FL
Zip Code: 34982 Fax: 772-465-8448
11
Phone No. 7(4 i
Phone No. 772-633-0740
I
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail: Etrian.Pearl@amerigas.com
State or County license: 02707128579
from the Owner listed above)
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if value of construction is sz5uu or more, a MILUKUcu Imumc us •� _•.••••
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PSIGNER ENGINEER:
e Not•Applicable
MORTGAGE COMPANY:
_, Not Applicable
Name:
Name:
Address:
Address:
Stater '
City:
1 State:
City:
Zip: phone:
Zip: Phone:,
FEE SIMPLE TITLEHOLDER:
Not Applicable
BONDING COMPANY:
of Applicable
Name.
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: 'Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit; to au ine wum w pu 191,L0110 NU91
I certify that no work or installation has comment ed prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure.
which is in contiict 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 4m,�_ents to your property. A Notice of Commencement must be recorded and posted on the jobsite
fore tfiV fir* inspection. if you intend fo obtain finan �c gsultfiv�ender or an attorney before
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Signatur=offtent/ Lessee
actor/License Holder
=STATEFLORIDA
STATE A
COUNTY OF t,_>C_AR
COUNTY OF mz
The forgoing instrument was acknowledged befo
le me
The forgoing instrument was acknowledged before me
thisa day of . 20 ►a by
this a. day of M c.rc . 20_�5C by
ccaS�•-
(Name of person acknowledging
(Name of person acknowledging)
(Signature of Notary Public- State of Florida)
(Signature of Notary Public State of Florida )
Personally Known �_ OR Produced Identification
Personally Known O, q u i c t•
Type of identification Produce
o t� -Notary Public State of Florid;,
of Identification P oduSed
. Angela M Boore
!a Boore
Commission No.G <---, k--'Z f ' (� GG 190609
a ommissior
4 n (V�jnission GG 190609
C mission No. off° Expires D2/27/2022
y, A°or Expires 62/27/2022
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Kev. //LVl&I