HomeMy WebLinkAboutBUILDING PERMIT APPLPICATIONALL APPLICABLE INFO MUST BE COri F ETED FOR APPLICATION TO BE Cm
Date:l ) SCSCANNED Permit
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St. Lucie County REC
IBM Building Permit Applicatio MAY 16 2019
Planning and Development Services
Building and Code Regulation Division LPermitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 12 n ty; FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: Fuel
Address: 3 \ D CP Eb ti--11,% %yTP\,e_L t.r C-1 3,(C1L4 C-
Legal Description: i� d -A__ S L.Jz) L, 0 �
Property Tax ID #: d-3 a&1 , S-b a - O O 0" 1 - C)l7 D - (-p Lot No. --I
Site Plan Name: Block No.
Project Name:,
Setbacks Front )-a Back: 10 Right Side: 1 u Left Side:
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CO�ISTRUCTION'INFORMATION
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Gas
❑HVAC Tank
❑Gas
Piping
❑ Shutters ❑Windows/Doors
❑Electric 0 Plumbing
[]Sprinklers
❑ Generator ❑ Roof
Total Sq. Ft of Construction: S Ft. of First Floor: _
Cost of Construction: $ �� O ' Utilities:Sewer ❑Septic
Building Height:
OWNER%LESSEE: _. ;,
CONTRACTOR. =°
Name(dVxS Y1/L t_ e-Al D
Name: Larry Licastri
Address:31 D \.D Sb1 �k1., QY��VSwt' k�.
Company: Amerigas
City:J-)VT PIQr-(_t State:
Zip Code: G1 LA Fax:
Phone No. ril -" U,1 "i 7 3-2
OleandeAve
Oleander -Ave
City: Fort Pierce State: FL
Zip Code: 34982 Fax: 772 {65 8446
Phone No. 772-633-0740
E-Mail: o \.(,\ sn, U`� 1
Fill in fee simple Title Holder on next page I different
from the Owner listed above)
E-Mail:
N. �M
State or County license: 02707/28579
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
MORTGAGE COMPANY: _ Not Applicable
Name:
DESIGNER/ENGINEER: _ Not 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:
--•• v �-• r -.r , wn mrrrvvrr : Hppucanon is nereoy 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
TO 0WNER: YOUR FAILURE TO RECORD A NO
FO�THP
EMENTS TO YOUR PROPERTY. A
B SITE BEFORE THE FIRST INSPE
UOR AN ATTORNEY BEFORE RECOR
as Agent for Owner
COMMENCEMENT MAY RESULT IN YOUR PAYING
MF COMMENCEMENT MUST BE RECORDED AND
F U INTEND TO OBTAIN FINANCING, CONSULT
NOTICE OF COMMENCEMENT-"
Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF S�- Li.7CtQ
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this L(Q day of MCA\ • ` 20J�J by this j<= day of N)QlY, 20n by
Name of person rhaking statement. Name of person making statement.
Personally Knownx_ OR Produced Identification
Type of Identification
Produced �h NMwryfublic State of Florida
K Angela M Boore
MYCommi6sio0GG790609
o Expires 0227/2022
(Signature o Public - State of Florida )
Personally Known _y— OR Produced Identification
Type of Identification }
Produced t v* °<e Notary public State of Florida
I� p• My Commission GG 790809
or Expires 02/2712022
(Signature of Notary Public -State of Florida )
Commission No<;64," (Seal) Commission No.�=11 [�oq (Seal)
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