HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date:-/2-/7, b 7 Permit Number:
SCANNED
BY RECEIVED
s St.
Lucie County
Building Permit Application DEC / 8 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Commercial X Residential
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Fuel
i`,PROPQSED
IMPROVEiVIENT
LOCATION
„ r ,;
Address:
Legal Description: fI " i1 TnG°orS���u� D rf'
Property Tax ID #: 11/29-S0/- 00-�_Z 000 -7 Lot No.�
Block No. Al
Site Plan Name:
ProjectName: .Se-44 C a ;�-
Setbacks Front___LtZ Back: /— Right Side: 0 Left Side:
DETAILED DESCRIPTION OF WORK"""',
$•e �' 2- 12_D I/B^/��.v�P�."l�a.sG'-1Gn.l� �-: � fa��•Y.� . 2un /;.re e+U�trr c�v�a"t
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CONSTRUCTION;INFORMATION,„
mono wor to e e orme under tispermit-a ec a apply:
KGasTank &GasPiping ❑Windows/Doors
UHVAC _Shutters
0-Electric EiPlumbing Sprinklers 11 Generator Roof
Total Sq. Ft of Construction: Sq� FFtt.I of First Floor:
oVo Height:
Cast of Construction: $ b� gS, Utilities: LJSewer Septic Building
OW N'`
ER'/LESSEE: z
CONTRACTOR
Name S� CoeS�
"� C�67 �r�,w.
Name: Larry Licastri
Address: 7/02L- "
Company_ Amed as
City: ro i F;e.-oe State: )_=(-
Address:3301 Oleander Ave
city: Fort Pierce State: FL
Zip Code:-3q'-1Fax: -
Phone No. 7% 2 W .5- 7 Td
Zip Code: 34982 Fax: 772-465-8448
E-Mail:
Phone No. 772-633-0740
Fill in fee simple Title Holder on next page ( if different
E-Mail: Brian.Pead@amedgas.com
from the Owner listed above)
State or County License: 02707/28579
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State;
City. State:
Zip: Phone:
—
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Sc Not Applicable
BONDING COMPANY: 2Not Applicable
Name:
Address:
City:
Zip: _
Phone:
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 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 Homeowners 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 1 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 twice for
impxximkinents to your property. A Notice of Commencement must be recorded and posted on the jobsite
fore t fjrrns�ection. If you intend to obtain finan ' J,� c suit vl h lender or an attorney before
mon na ae r rarnrdinv vnur Nntire of Commen em-- nt lQ
Agent/ Lessee
Signatur o=IR
a ure o ntractor/License Holder
A S1' ��(
St.LMU P_
COUNTY OF l2
COUNTY OFORIDA
The forgoing Instrument was acly�owledg d before me
= M,
The for oing instrument was aclI��nnowledged before me
dayof Pe-r- �1 by
thisZdayof� by
this 00ew.20
l c rru L� ri
� Ll c Gs; �
(Name of person owledgin,{)�
(Name of person acknowledging r
Notary Public- State FI rida )
(Signature of ffotary Public- State of Flo iida)
(Signature of of
Personally Known a
onally Known _X entif�R 1 DIAZ
_X
Type of Identification Produc d; i�" AMBERTDIAZ.
Ti a of Identification Produce =' glM�N r FFefie
=`• •: MY COMMISSION M FF9R
Commission No. 51P 145 ' (200"ESF&Wwry0i.21200
'I
toy g February Ot. 20
a+s�
mission No. FF956M1519111
'wviw.mn
HonrJO
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
'MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Hev. 712014