HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL PPLICABLE PYFO UST BE COMPLETED: FOR APPLICATION TO BE ACCEFrED
Da , Permitpumber:
SCANNED
BY RECEIVED
B 1 MgCOMit Applica ion jUL 0 3 2018
Pla ning and Development Services ST.. Lucie Country, Permitting
Bui ling and Code Regulation Division
23 Virginia Avenue, Fort Pierce FL 34982
Ph q ne: (772) 462-1553 Fax: (772) 462-1578 Commercial _ Residential_
IT APPLICATION FOR: Fuel
LM4 Description: _
Prop rty Tax ID #: 3�� — 1 _ D Lot No.
Site I Ian Name: Block No.
Proje ct Name:
Setb„ cks Front _ Back: Xd Right Side:1 Left Side:
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i�jiona wor toe a orme unert is permit —c ec . all apply:
—, HVAC Gas Tank ❑Gas Piping M— Shutters Q Windows/Doors
Electric ❑ Plumbing OSprinklers 01 Generator 0 Roof
Total q. Ft of Construction: S . Ft. of First Floor:
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Cost f Construction: $ ��-C� Utilities: JSewer Septic Building Height:
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Name: Lary Licastri
Company: Ameri as
Address: 3301 Cleander Ave
City; Fort Pierce State: FL
Zip Code: 34982 Fax: 772-465-8448
Phone No. 772-633-0740
E-Mail: Brian.Pearl@amedgas.com
State or County license: 02707/28579
ss: �-9
State.? —
de: aUl gIA3 Fax:
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il:
i fee simple Title Holder on next page (if different
he Owner listed above)
ifvalge of construction is 525oo or more, a nruunvu, n.utmc V■ L■+•■■■�•�••��•••"•- •—'�y■.••c..•
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SIGNER ENGINEER: _ Not•Applicable
{MORTGAGE COMPANY: Q Not Applicable
me:
Name:
.4 dress:
Address:
C ty:
State:
'City:
State:
Z p:
Phone:
Zip: Phone:
F E SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY:
of Applicable
me•
Name:
Address:
Address:
e ty:
City:
Z
Phone:
Zip: Phone-
O NER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to clo the worK ano installation as ma lcatea.
I rtify 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
w ich is in conflict with any applicable Home Owners Association rules, bylaws orand covenants that may restrict or prohibit such
st ucture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. j
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in ccordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
T following building permit applications are exempt from undergoing a full concurrency review: room.additions,
a essory structures, swimming -pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
RNING TO OWNER: Your failure to Record a Notice of Commencement may result in your, paying twice for
i ments to your property. A Notice of Commencement must be recorded and posted on the jobsite
for
t fir$jectlon. tf you intend to obtain finan ' ,, c� suite (lender or an attorney before
�.
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natur of Agent/ Lessee
ractor/License Holder .
a ure TFLORI
S7,
C
ATE O RIDA
LINTY OF �� �7y
STATE DA
COUNTY OF
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forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
by
th
�_ day ci 3� . 20 t % by
this c;�L_ day of 201�
I
(Nime
of person acknowledging)
(Name of person dcknowleldging
(S
atur ary Public- State of Florida)
(Signature of Notary Pu tc- State of Florida )
Pe
i
rsonally Known O
sonally Known i� _ OR
Ty
a of Identification Produc Notary Public State of Florida
__I:
e of Identification Produced Honda
Co
MyC mmiasion GG t9oso9
mission NO.('� 1c10 (Rgpl�s02/27/2022
1
Angela M Boore
owoq
C mission No. l i$�d s 02/2 /2 GG 111
?pl xpl es 02127/2022
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VIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE .
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
D
E
R
EIVED
D4TE
COMPLETED
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