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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAdEL ALL APPLICABLE INFO MUST BE COMPLETED. FOR APPLICATION TO BE ACCEFI-ED Date: ' l 5 Permit umber: cAmm BY ram�r, ��.,, St. Lucie Capj RECEIVED " - Building Permit Application JUL a 5 zl��� Planning and Development Services Building and Code Regulation Division Permitting Deportment 2300 Virginia Avenue, Fort Pierce FL 34982 St Lucle / a ntial Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Resident PERMIT APPLICATION FOR: Fuel }('{� t �(j Y .l. a•"1-��/1�? S.YF {��( � i F B "GH y `4 5 t L.y `v F ,, I t'Y.y �< 4 f �� I aS7Ji Y'•) L.. ii . ..VJ 1 1 I �i ..V, f ; i .'u. .�V!•Y* e..-, . -stt , ... .. .^: Y. •. . e :..1 _. .ter .. >•.. vl Address: 1 Legal Description: Property Tax ID #: ty�i"� ' ©� ��� _ Lot No. Site Plan Name: C-Y•] n Block No. Project Name: Setbacks Front_ Back: \© Right Side: o Left Side:\41�:) d . + c �1'AF RSCI�lflk Q�} ti r lad 'yz t r 2 M F . w nk . •.k. .t ..ir., be 41- to un ert is permit—c ec a apply: Addl—tional work De Dej rmed . ❑Gas Tank RGas Piping Shutters ❑ WindowsJDoors HVAC LJ _ [:]5prinklers [ 011oof ❑_ Electric L� Plumbing Generator Total Sq. Ft of Construction: o2�5 ` 5 . Ft. of First Floor: Cost of Construction: $ - UtilitiesSewer OSeptic Building Height: 0;7,. I�Ir�f L��E�, i Y I : C011�TRT lCTf3R l t •,F , t � � ; y n Name: Larry Licastri Name ��1 �1�b• Company: Amerigas Address: Address: 3301 Oleander Ave State: fL City. Fort Pierce State: FL Ci Y�1 /(�Q EI� Zip Code: 3 L Fax: Zip Code: 34982 Fax: 772-465-8448 Phone No. ���,� E-Mail: SEAI)o6rl. YAHoO•!AM Phone No.772-633-0740 E-Mail: Brian.Pearl@amedgas.com Fill in fee simple Title Holder on next page ( if different State or County license: 02707/28579 from the Owner listed above) I If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. . NGINEER: _ Not Applica Name: Address: State Zi0: Phone SIMPLE TITLE HOLDER: _ Not Applicable me: dress: i'' Zib: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip: Phone: ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. y that no work or installation has commenced prior to the issuance of a permit. e County makes no representation that is granting a permit will authorize the permit holder to build the subject structure ~ s in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such re. 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 ComMeW0m--e_nTWw result in your paying twice for imp em to yo roperty. A Notice of Commence ent mu a recor d and posted on the jobsite befi a the fir s ectl n: If you intend to obtain financ nsul ith lend r or an attorney before com ncing o or rec rdine"vour Notice of Commence ent. SignatuZessee/Contractor as Agent for Owner ure of C n or/License Holder STATEIDA S. T�OF ORIDA C UNTYOF S� l ssZ. CO SV LX-.)c 14Z The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 4 day of20%X by this �3 day of 20tk by �I Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known _\,el OR Produced Identification Type of Identification Type of Identification Produced Produced ignature ublic- S • to on �� ry Publicof Flori �gEla " igature o otary Public- Stat o 0 a ;.� Notary Public iBoo�e of FI Commission M B ore No. `� s( 9Wommission GG 19060 a° M Cor'' nission No. iGC) Commission GG Expires 02/27/2022 190 �✓ ? dF Expires 02127/2022 (REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE II COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ATE ECEIVED DATE COMPLETED 8/2/17