HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO. MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1q03
J��i I Permit Number: "
Date:SCANNED
BY
o - St. Lucie County R6CZrVFo
Building Permit Application Ma .
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Planning and Development Services P ?O1B
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Building and Code Regulation Division Sp, 9 ae
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2300 Virginia Avenue, Fort Pierce FL 34982 Cpun
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Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Fuel
PF20 OBE ROWMANTION
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Address: �- 0 SC��/ in �� 6( 1A S'`(Y tx- - .�r� 1-eX L P
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Legal Description:lhd L uN\
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�C O D 3 6, — O i) O Lot No.
Property Tax ID M.
(013
kVt dl (LM V�rv-e_� k C Block No.
Site Plan Name:
Project Name:
Setbacks Front D Back:1y Right Side: 1 0 Left Side:
[Ai1k3DESCfR1PT10NtIFWORK
�,� , �-4 �. �`S , �Z� F> - ,tee _ r► �\ a s-F� tV-\
ACIC10tional WOrK to UU e o me un er t is per — c et a app y:
❑Windows/Doors
CJHVAC Gas Tank as Piping _Shutters
0 Plumbing Sprinklers Generator 0 Roof
Electric
Total Sq. Ft of Construction: SgI�Ft.� of First Floor:
ElSeptic
Cost of Construction: $ Utilities: Sewer Building Height:
OTA(Nl;kjLESSEE
,
GON7RACTOR.«rw
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Name: Larry Licastri
Name
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Company: Amergas
Address: �i'�\ C �Ay(ti.t�ln6'ln
9oX L -c State:_
Address: 3301 Oleander Ave
City: Fort Pierce State: FL
City:
Zip Cade: Fax:
b 3u�i �) b Lp
Zip Code: 34982 Fax: 772-465-8448
Phone No.
Phone No. L%nz-7904
E-Mail: \.l /` � IlVi f 0V"L
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Fill in fee simple Title Holder on next page ( if different
E-Mail:
State or County license: 09W/28579
from the Owner listed above)
If value of construction is $25oo or more, a RECORDED Notice of Commencement is required. .
W
DESIGNER/ENGINEER: _ Not Applicable
Name:
AOL
MORTGAGE COMPANY: Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 indicated.
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 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 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
EMENTS TO YOUR PROPERTY. A NOT O COM CEMENT MUST BE RECORDED AND
B SITE BEFORE THE FIRST INSPECTEN: I YO INTEN TO OBTAIN FINANCING, CONSULT
LENDER OR AN ATTORNEY BEFORE RECO Y R N MENCEMENT."
*OnLer/
e/Contractor as Agent for Owner
Signatur f Co tractor/License Holder
STATE OF FLORIDA
COUNTY OF S\—
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
thisa,-Ir day of 20AS by
The forgoing instrument was acknowledged before me
thisoZ day ofM(nk c�h 2014 by
V LAi_C C1
1 L\ C \-Cl
Name of pers n making statement.
Name of person rAaking statement.
Personally Known 2�__ OR Produced Identification
Type of Identification
Personally Known _K__ OR Produced Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- t t
Ngtary Public State of Florida
-A'"nggela''M Boore
No \ O nt�ttnissloncc1e0609
or Expires 02/27/2022
fignature of Notary Public- S t�pf rid�ry Public State of Flofida
An ela MBoOre
9Commission
mmissionNo Vqk �YCgr� 1271nGG790609
2/27/2022
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.