HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO M
Date: , S 7
Planning and Development
Building and Code Regulatio
2300 Virginia Avenue, Fort
Phone: (772) 462-1553
T BE COMPLETED FOR APPLICATION TO BE ACCEPTED �
Permit Number: O Q O — i? L
SCANINED 'EC001"D
BY K t: v t:
SK Lucie'Countv
Building Permit Application MAY 0 7 2018
ervices
iDiv►Sian Permitting Department
erce FL 34982
ox: (772) 462-1578 Commercial es&niiMci u nty, FL
PERMIT APPLICATION FOR: Fuel 1 1
Address: 1 L4�
Legal Description:
PropertyTax ID #: 1:n5�Q `7 \
Site Plan Name:
r
Project Name:
Setbacks Front Back:
3C—_ p%k_)4
&XIVA bca \:1'1 . � 0 -�On
—E)00Q —000 -- '
Right Side: \0 Left Side: \0'
ss wpm
Lot No. a
Block No. L4C)_
Additional work to VertorImea unaer mis permit — cnecK du aNNly:
E1HVAC Gas Tank gas Piping _ Shutters ❑ Windows/Doors
L1Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of"Construction: S . Ft. of First Floor:
Cost of Construction: $ �� .�� Utilities: Sewer Septic Building Height:
1`.
r
OWNER/LESSEEr
Name ���" `I�HV�%�`�n}
Name: Lary Licastri
Address: :-(001 Qr^G;��7L��
Company: Amerigas
City: art- V 1JbrL.G State: �E_L
Address: 3301 Oleander Ave
Zip Code: 't9s 1 Fax.
. Fort Pierce FL
City. State:
Phone No. 5- S%S
Zip Code: 34982 Fax: 772465-8448
E-Mail: I
Phone No. 772-633-0740
Fill in fee simple Title Holder on next page (, if different
E-Mail: Brian.Pearl@amodgas.com
from the Owner listed above1)State
or County License: 02707/28579
If value of -Construction is 5z5ou or more, a KtGUKUtU Notice oT commencement is requires.
ALL APPLICABLE INFO MUST BE
Date:
ED FOR APPLICATION TO BE ACCEFrED
Permit 0 umber:
ing Permit Application
Planning and Development Services
I
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
I
PERMIT APPLICATIONFOR: Fuel
Address: I \JQ
Legal Description:
Property Tax ID #:
Site Plan Name:
Project Name: —
Seitbacks Front-
ON
Lot No.—Q
,C-P Block No. L4L
Back: Right Side: Left Side:
a h 100 1 zl_
-Nf"C'
,
0,NtAT.,-
Additional worKtO BWGas
ormeetMe� permit— clec, all apply:
E1HVAC I Tank Seas Piping Shutters ❑ Windows/Doors
ElElectric 0 Plumbing []Sprinklers Elenerator 11 Roof
'total So. Ft of Construction: S Ft Septic Building Height:
of First Floor:
—_
Cost of Construction: $ utilities Sewer 11 1
Name
Name: Larry Licastri
Address:
Company: Amerigas
State:
Fax-
City:
Zip Code:
Phone No.
Address: 3301 OleanderAve
City: Fort Pierce State: FL,
34982172465-8"8
Zip Code: Fax: -
E-Mail:
Phone No. 772-633-0740 -
on next page: if different
Fill in fee simple Title Holder
from the Owner listed abovp)
E-Mail: Brian.Pearl@amerigas.5�
State or County License: 0270/28579
f
IIIf value of construction is$250 or more, a MILUKUtU IM011ce Of L.L1911111=11%.W9513 aucclumau.
. 'Y+cy;r n' -•i f✓{i r -a+~"v
.r - T✓ i•�
�
;
m. ` •. Elmr`
�DESIGNE�t ENGINEER: �� �
Not•Applicable t
MORTGAGE COMPANY: •_
Not Applicable
Name• I
Name-
Address• I
Address•
State:
City:
I State:
City:
Zip: Phone:
'
Zip: Phone:
FEE SIMPLE TITLE HOLQER:
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
j OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to oo ine worK dnu In5ld1Idl1UJ, db III .UILdlCU.
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 orand 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 grardIrig of this requested permit, I do hereby agree that I wilt, in all respects, perform the work
j 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,
s, walls, signs, screen rooms and accessory uses to another non-residential use
accessory structures, swimming pools, fence
i WARNING TO OWNER:I Your failure to Record a Notice of Commencement may result in your paying twice for
n
e its to yourproperty. A Notice of Commencement must be recorded and posted on the jobsite
fir ipection. if you intend to obtain finan , c sult lender or an attorney before
na-ark bLr�•�Lding�+ourINotice of Commen menu
STATE OF'FWRIDA�
COUNTY OF
The foroing instrument
this ' day of dot
LC'C'cam y
Blame of•oersoD_
Lessee
vas acknowledged before me
.20A by
e
Notary Publics State
Personally Known _/�-_
Type of Identification Pro
Commission No. C=96l
�at�e��•�,.
Notary Public
Angela M Baore
My m ission GG 1 iL•.: •
Eu/27/2D22
signa ure or n[rac[oryucense nwuc�
STATE FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
thisa"' day of MCr.Y . 20Al by
e
lrc�s�� c.s�S� � •
(Name -of persori acknowledging
(Signs otary Public- State of Florida)
Personally Known �_ O
Type of Identification Produce ,sae Notary Public State t FlorirJ;
Angela M Boore
c pp��y, mission GG 1906o9
Commission No. ��� 04,02127/2022
REVIEWS I FRONT � COUNTER IVE
VIEW I S REVIEW VISOR I REVIEW I VEGETATIPLANS ON
I SEgETURTLE_ MREVI W
DATE MAY 10 8 2018
COMPLETED
Rev. ST. Lucie county, Permitting