HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: —( Permit Number:
Building Permit Application Set,9 yap
Planning and Development Services �11C,90 010,
Building and Code Regulation Division cO41, 'Ile,
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Fuel
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Address: D(/SS
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Legal Description:
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Property Tax ID #: J�? 9 -\ -'-I D D - O D 'DI--( - DO 0 - C� Lot No. 3
Site Plan Name:
Project Name:
Setbacks Front_ Back: I L)— Right Side: 1 D Left Side:1 O
Block No.
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OHVAC Gas Tank as Piping _ Shutters ❑ Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers Generator 1:1Roof
Total Sq. Ft of Construction: �� /,'
Cost of Construction: $ S� ( I J 1 1
S Ft. of First Floor: _
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Building Height:
DOWNER/L'ESSEE � � ;" h �
CONTRACTOR
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Name 2IVKN i'6V1S+VxA(--h✓ b)
Name: Larry Licastri
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Address: �1 to 0 l D���n(ti\/ ��✓ /--A
Company: Amerigas
city: , O3 (�ie2 V LC State
Zip Code: �Lk 01 `A Fax:
Phone No. 'Y1 L - a'D 1 - '�A I'd Z
Address: 3301 CleanderAve
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772465-8448
Phone No. 772-633-0740
E-Mail: kV.<-�- e IM_ed� C \,2e \1 1
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: Brian.Pead@amerigas.com
State or County License: 02707/28579
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
Name:_ _
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:_
BONDING COMPANY _Not Applicable
Name:_ V\
Address:
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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
nOIT
FgYEMENiS TO YOUR PROPERTY. Am kMENCEMENT MUST BE RECORDED AND
NTH OB SITE BEFORE THE FIRST INSPE�Qr ION. 1 OU 1 END TO OBTAIN FINANCING, CONSULT
0 END OR AN ATTORNFV RFFnPr NFfn 1 ynl NnTI c nc �nuuru�curur n
SignWofessee/Contractor as Agent for Owner
actor/License Holder
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COUNTYOF ly�,Q
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The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this %46 day of 20—a by
this 1(o day of t\,j)Clk by
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Name of person iNiaking statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known_ OR Produced Identification
Type of Identification
Type of Identification
Produced
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Produced
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(Signature of Notary Public -State of Florida )
(Signs ure of Notary Pu '
Commission No��tgOf�Jq (Seal)
Commission NoC�1� (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
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EDATE.11