HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL I PLICAB INFOjM% UST BE C011OL i ED. FOR APPLICATION`TO BE ACC t�um ber: 09' "` �`'
Dat : • /� Perm
OUNTY
Building Permit Application SEP 1 8 2018
ing and Development Services P e r m i tt i ri D ,0 Ip a rtm 2 t
ng and Code Regulation Division 1.0 C County, I'
Virginia Avenue, Fort Pierce FL 34982 R
e: (772) 462-1553 Fax: (772) 462-1578 Commercial
APPLICATION FOR: Fuel
4-
414z
,ss, Zav r e - - - - By
Description: —trtucie County
OZ- O v0 Lot No._
y Tax ID #: 24 1 DO Block No.
i Name:
Name: V36:&uelt�
Back: ) O Right Side: �- Left Side:
cs Front__—
AW
se'�- l 91'l►on &�•►� ��d i'vr� 9r.S link � fAle '0►nd 'W
bona woo
e
mrider i
u
❑Windows/Doors
�HVACGas
Tank
Gas Piping _Shutters
0 Generator
DRoof
❑
Electric ._
Plumbing
Sprinklers
Sq. Ft of Construction:
S .
Ft. of First Floor:
USeptic
Building Height:
of Construction: $
z3-z • �$
Utilities-lb,
ies: b — Sewer
ne
Iress:
State:
Code: Fax:
me No.
hail:
in fee simple Title Holder on next page (if different
n the -Owner listed above)
Name...Larry Licastri
Company: Amengas
Address: 3301 Oleander Ave
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772-465-8448,
Phone No. 772-633-0740
E-Mail: Brian.Pearl@amerigas.com
State or County license: 02707/28579
of construction is $2500 or more, a RECORDED Notice of commencement is required.
DE IGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Na ', e:
Name:
Ad ress:
Address:
City State:
City: State:
Zip, Phone
Zip: Phone:
FEt SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
_
Name:
Name:
Address:
Address:
Citiy:
City:
Zip: Phone:
Zi�l: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
Ice ify that no work or installation has commenced prior to the issuance of a permit.
St. L�cie 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 and covenants that may restrict or prohibit such
stru cure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cc �lsideration 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 Iollowing building permit applications are exempt from undergoing a full concurrency review: room additions,
acces1sory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
W IRTO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
i ovemV11
ur property. A Notice of Commenc ent m r rded and posted on the jobsite
e I re thensp tion. If you intend to obtain finan in , coi u with le der or an attorney before
m`anrna vniir Nntirp of Commen _m _nt
Si
" ature o essee/Contractor as Agent for Owner
C n actor/License Holder
S
OF ORIDA
�njature
FLORIDA
C
l U F �V
COUNTY OF -nr
T
e forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
20) by
th
s kti day of9z%-.jLcem\cR_7— , 20A-A_ by
this k—_ day o1�2Tgxh1 � ,
Name of pe son making statement
Name of n making statement
P
rsonally Known OR Produced Identification
Personally Known OR Produced Identification
T
Ipe of Identification.,-
, Type of Identification
PirOdUCed
sr ot. Notary Public State of Florida
Produced op p�-, public State of Florida
a Angela M Boore
Angela M Boore
My Commission GG 1906019
a �Qoia Expires 02/27/2022 i
My Commission GG 19b609
4
AV
'ASP Expires 02/27/2022
r
(
signature of ary Public- State of Florida)
(Signature of Notary Public- State of Florida )
C
mmission No�-� kROf'-tn (Seal)
Commission No.�� (Seal)
IEVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
ATE
RECEIVED
ATE
OMPLETED
8/2/17