HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED. FOR APPLICATION TO BE ACCEIC
Date: I Permit iJ umber: `��' 3
Building'Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone. (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fuel
Commercial _ Re:
1 f or.11 91 i-
Legal Description C-
Propert� Tax ID #: -z,4zA - r23 000 _ 300 ^ 1 Lot No.
Site Plan Name: Block No.
Project Name: 1.-d,n �-2 �) m) B S ����y�
Setbacks Front jO Back: 0 Right Side: Left Side:
:., ,,�7w �� v. }� :'i...�., { .�.+�r�t f}��;.: e• v.•., f �� �� k � i�s4 �' k. t � ,, ... -.: L4'"� 1 ��1h �y r �;' "� r �, � it 4 s,kyt
,�- ►to C J I l oti A bov e �#-&,A-►cl + �- on 1J- I evks G ,10F V'4/✓1 �. s
ane �-o r�. tge A^ol
4
rrTi � i/�T11 fhr lh E(1[?mlAi . _s
ertms permn.-
Tank . Gas Piping U Shutters
❑Electric 0 Plumbing LJSpr
Total Sq. Ft of Construction:
Cost of Construction: $ `W 17� '� Q
5
ars U- Generator
S . Ft. of First Floor: _
Utilities:Sewer USeptic
City: State: rL
Zip Code: ) Fax:
Phone No.�'Z'
Fill in fee simple Title Holder on next page ( if different
from the. Owner listed above)
QWindows/Doors
11 Roof
Building Height:
Name. Lary Lioastri
Company: Amerigas
Address: 3301 Oleander Ave
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772465-8448
Phone No. 772-633-0740
E-Mail: Bdan.Pearl@amedgas.com
State or County license: 02707/28579
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not App
Name:
Address:
City: State:
Zip: Phone
FEE SAMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: I Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie ICounty 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
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 l 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
WAR TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
i oveme o ur property. A Notice of Commence us
orded and posted on the jobsite
b fore the it t inspe tion. If you intend to obtain fin Ing, con t with der or an attorney before
co �'ncin rk or necordine your Notice of Commen ent.
I
Ign tune o Lessee/Contractor as Agent for Owner
' atu�reror/LicenseHolder
STATE ORIDA
STA
COUNTY OF �Ek LC�Q
COUNTY OF y'S;NR_
The forgoing instrument Vw acknowledged before me
The forgoing instrume t w s acknowledged -before me
thiS'�' day of 20A by
this day of�-�� 20Mby
Name of pers n making statement
Name of pers making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type ofildentificatiaft `
Type of Identification
Prod Notary Public State of Florida
Produced •/ Notary Public State of Florida
ore
Angela M Boore
Commission GG 190Fr)9
Expires 02/27/2022 .
My Cn GG 190609My
La
+1Expir2022
«
(Signat lure u lic- State of Florida)
(Signature of Notary Public- State of Florida )
Commission N�')kC A (Seal)
Commission N E{Oq (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17