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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL INFO MUST BE COMPLETED. FOR APPLICATION TO BE ACCEFI ED Permit it umber: O " CON �"1 SCANNED BY St. Lucie Cwty Building Permit Application r and Development Services and Code Regulation Division ginia Avenue, Fort Pierce FL 34982 (772) 462-1553 Fax: (772) 462-1578 IT APPLICATION FOR: Fuel Id Legal Qescription: RECEIVED AUG 2 8 2010 Permitting Department St. Lucie Countv Commercial _._ Residential Prope i Tax ID #: �1403 -507 - n09 ' Lot No. Block No. Site PI n Name: Proje Name: S i rranh Qeh1V /bid in9S TI.,L C 00):jn4 Setba ks Front Back:—) Right Side: Left Side: ���f *}� k v �lt.r tiyry 1r5�i4K�r4rf rWL.1 1}vi�..V 4u ii r:. ua� ����i'[ ����� l ��rli r I f u71,... rt., 1r.. ...5✓ `{:. .,t`r,.'r .�.w .. .. ,�... Z0.. 0n 6 locks Arlt AnVorr, wn 40 Fes. 1opper +0 � M9^�V���9 s*b 0110d sn1,Ke, �4s &v0?,,CCA749"- al work to 6e Dertormed unaerirns perms-u)e�R tlrl ©Gas Piping aNNlr• Shutters ❑ Windows/Doors AC z G as Tank _ ctric ❑ Plumbing OSprinklers 01 Generator Roof Total Sq. Ft of Construction: S . Ft. of First Floor: Cost of Construction: $ i ZOO . �Z9 Utilities:l Sewer USeptic Building Height: OVI/I�R/L�SSf� 011IT# �CT�R x Name I S; rro") e+ro 04%n T,, L Name: Larry Licastri Addre Company: Ameri as ' : Z14 }S M 1 �w�.l 2Q�,c� City: Address: 3301 01eander Ave Fr e State:.. f L Zip Code: 3qO Fax: City: Fort Pierce State: FL u o. _ (o (0?� Z j$ j �V=1 Zip Code: 34982 Fax: 772-465-8448 Phone E-Mai Phone No. 772-633-0740 S t"rOn'1 n10Cn�C'S C�/'1�4Z 1. �� Fill in f E-Mail: Brian.Pearl@amedgas.com I: e simple Title Holder on next page ( if different from t e Owner listed above) State or County license: 02707128579 if value16f Construction is $2500 or more, a 11MUMOCv IvuuLc WN w ...... •- .�y.,...... . I SUP ..# , .n LEMEN�ALCQN5TFtUCTIQN t a', LIEN I.AW INFQRMATIQN 11 's�'. DESIl Nam Addr'I 3NER/ENGINEER: _ Not Applicable I : MORTGAGE COMPANY: _ Not Applicable Name: ss: Address: City: City: State: State: Zip: I Phone Zip: Phone: FEE Name: Address: City: 'MPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Address: I City: Phone: I Zip: Phone: Zip: I OWNI R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to.do the work and installation as indicated. I certif that no work or installation has commenced prior to the issuance of a permit. St. Luci which i structu In consilderation in accoi County makes no representation that is granting a permit will authorize the permit holder to build the subject structure in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work fiance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The foll ),wing 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 WARII ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for im b fort ur property. A Notice of Commenceme ust b ded and posted on the jobsite anrstinnection. If you intend to obtain financi ,con It ith len er or an attorney before c m n ir recording our Notice of Commence .. ent. Signatu of Co tractor/License Holder ig a -ire o Lessee/Contractor as Agent for Owner STAI FLORIDA STATE OFF ORIDA COU TY OF SI- L- _-l;I COUNTY OF Sk' The fc thine? rgoing instrument was acknowledged before me day of CAj � 2011% by The forgoing instrument was acknowledged before me this a2L day of r-4_%MV1E k 20 tc.6 by Perso Name of person making statement I ally Known X OR Produced Identification Name of erson making statement Personally Known _)k OR Produced Identification Type Prod f Identification ced State of Florida c ZAngela Z.r ore n GG 190609 ?a66ffa��2022�, Type of Identification Produced , NotaryPublic State of Florida o Angela M Bo4re My Commissiori'GG 190609 Ex ' \ (Si ure of Notary Pu c- a e (Signature of Notary Pu ' Comff ilssion No G4Zs <<10 (,09 (Seal) Commission NoGG 1c10ro(4) (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATEI RECEII ED DATE1 COMI1,LETED Rev. 8/ 17