HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ¢, c
Date: 3 I S OCANNEW Permit Number:
Building Permit Application =Emo
Planning and Development Services JUL G,
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Itting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial RINleal
111 PERMIT APPLICATION FOR: Fuel
Address: '5' -2 0? ycee- Ltn �/
Legal Description: Xgledew
Tax ID #: Q /3 - S-02-•60Z3 - 00y- -L Lot No. W.44'
Plan Name:
Block No.
act Name:
Jacks Front Back: /_ Right Side: t' O Left Side:1Q_
nt aa_"y: ski , s`r vs, "'�, � � .ti•, .� ..�- 8 _ . its Sv �r .4:N.
p
u / f/ s OO ya9�- (M�t�G�� )p+^!. �'w a %ticc
ional work to be erro mea
HVAC Gas Tank
under trns ermn: - cnecK au
Gas Piping
_
apply:
Shutters
Electric
El
Plumbing
Sprinklers
11
Generator
Sq. Ft of Construction:
of Construction: $ 2 2 S, a-0
S Ft. of First Floor: _
Utilities: Sewer Septic
11 Windows/Doors
0 Roof
• Building Height:
..e'
6'UNl� ., . ,.,r� , n -,� s. ,.�. �•5::'-' _.�,y� ? h,..... ,�� r 5 »„ .;:'s.:`e ,_.t'.�"_n...
�19ONER/LESSEE .� t.. x
,'.CONTRACTOR r r
Na re V /i tar�� G%F� i
Name: Lary Licastri
Address: 12, D3 32e'B/ u% 1%
Company: Amerigas
Ci4 c L �r�tG e- State: 1'=G
Address: 3301 Oleander Ave
Zip Code: T�t4.r / Fax:
City: Fort Pierce. State: FL
Ph II No. ''1 7.-� 3�y iY U
Zip Code: 34982 Fax: 772-465-8448
a
1
E- ail:
Phone No. 772-633-0740
Fill i�l fee simple Title Holder on next page ( if different
E-Mail: B6an.Pearl@amedgas.com
from the Owner listed above)
�I
State or County License: 02707/28579
If valise of construction is $2500 or more, a RECORDED Notice or commencement is regwrea.
ON M
✓Not
DESIGNER ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Applicable
Name:
Name:
Address:
Address:
City:
State:
City:
State:
Zip: Phone:
Zip: Phone:
.FEE SIMPLE TITLEHOLDER: VNotApplicable
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 do the work and installation as incl Icated.
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 andcovenantsthat 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
imm%w,ments to your property. A Notice of Commencement must be recorded and posted on the jobsite
fore tfiV firg inspection. if you intend to obtain finan ' , c Iysult n i\lender.or an attorney before
Lessee
Holder
STATE OF'FORIDA I STATEOrFLORIDA
COUNTY OF S� �U COUNTY OF
The forgoing instrument was acknowledged before me
this �_ day of 20 <<C by
The forgoing instrument was acknowledged before me
this day of -5y\ 20_& by
(Name of person 'acknowledging) (Name
( rgna ublic- State of Florida) (Signal
of Notary Public- State of Florida )
Personally Known :g I— OR Produced Identification Personally Known _ C
Type of Identification YeNotary
pe of Identification Produc
,:,on,Produ
o ary Public ate ofFlgrda
n
Commission No.q =issoGG 190609 mmission NdZ O
Y0-,-V. Expires 02/27/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION
COUNTER REVIEW REVIEW REVIEW REVIEW
DATE
Boore
,sion GG 100609
SEA TURTLE MANGROVE
REVIEW I REVIE,:W