HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1LL APPLI LE 1 FCO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED'
Date: J0 SCANNED Permit Number: l`� •CJy/
BY
5 ' St. Lucie County
o-
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 Commercial_ Residential
PERMIT APPLICATION FOR: Fuel III
Address: 13 2
Legal Description:
PropertyTax ID #: 2.3 aT— a 1 Z— 000/— 000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
o utsole ,,yes only �o„f�ew �„S,`aRe 1 rLer.
❑HVAC IJ Gas Tank
❑Electric ❑Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ W. 9
9
Piping ❑_Shutters ❑Windows/Doors
nklers ❑ Generator ❑ Roof
S Ft. of First Floor: _
Utilities:i Sewer []Septic
Building Height:
,OWN•ER/LESSEE:.' x . `�. �._ , � � fiu�
CONTRACTOR ��;�. , a • ... ::. �.�.r��
Name J c26 O 1K
Name: Larry Licastri
,
Address: 23.0 CA-e_!nd
Company: Amengas
City:Stater
Zip Code: 2YQ yS Fax:
Phone No.-7'71 6 2 02 M
Address: 3301 Oleander Ave
City: Fort Pierce State: FL
Zip Code: 34982 - Fax: 772465-8448
Phone No. 772-633-0740
E-Mail: Bdan.Pead@amedgas.com
E-Mail:
Fill in fee simple Title Holder on next page (if different
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 requrrea.
1'J
T
igg
DESIGNER ENGINEER: _ Not Applicable
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City:
Zip: Phone:
State:
Name:
Address:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
_ Not Applicable
BONDING COMPANY:
_Not Applicable
Name:
Name:
Address•
Address:
City:
Zip: Phone:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and instaiiatron as indicated.
I certify that no work or installation has commenced prior to the Issuance of a permit.
St. Lucie Coun�y makes no represent tion 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 orand 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 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
impxovgments to your property. A Notice of Commencement must be recorded and posted on the jobsite
fnlY6 rP tRp fii- nectinn. If you intend to obtain finanong, cagsult _vi ajender or an attorney before
STATE OFT-WRIDA IJtwi [ yr rLvrnvn
COUNTYOF St- ls�C�� COUNTY OF S11 tADciQ
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thiss_dayof A- �\ 201'6 by this oct daydf C- �c \ 20}is by
(Name of person acknowledging) (Name of perAn acknowledging
(Signature o ry Public- State of Florida) (Signature o o dry Public- State
Personalty Known O
ti ton
Personally Known_
Type of identification Pro u d
hype of Identification Produ ed
n a
r' AngellaM Boore
Commission No.. \ " IE8�1 mission GG 106609
xpires 02/27/2022
,� r
(commission N�-�G lest
Angela M Boore
�` MN$e'8 fission GG 190609
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