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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED yn Date: .43 t D Permit Number: O g SCANNED BY S Lucie. o nt RECEIVED Building ermi �p6lication Planning and Development services O6 2018 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 LLVAPR cie County, PermittinaPhone:(772)462-1553 Fax:(772)462-1578 Commercial Res PERMIT APPLICATION FOR: Fuel Address: j 0 Z /U Az'tipS. 9 Legal Description: PropertyTax lD #: 13 13— Z 37 Z - 000/- d OO—y Lot No. Site Plan Name: ProjectName: ©r, ,A Q hn Block No. Setbacks Front Back: Right Side: Left Side: z 2r9� S �DETA(LED DESCRIPTION;OF WORK �, • �, � , n-. , „ w; W, �� �� §.- _c 12�xe//canr�eedee�%y�r o s�gG e( �y,�o� l e µ "� war e E1HVAC �GasTank 0- Electric 1:1Plumbing Total Sq. Ft of Construction: Cost of Construction: $ ) 1 / 6. Piping apply: Shutters ❑ Windows/Doors Generator 0 Roof S Ft. of First Floor: _ UtilitiestSewer 0Septic Building Height: OWNER/LESSEEa CONTRACTOR ` Name AA Name: Larry Licastri Address: 972 -Z. I Al O'rAo, ee' jR1,C Company: Amerigas City: Stater Zip Code: is c) Fax: Phone No.72 2 S i r Address: 3301 Oleander Ave City: Fort Pierce State: FL Zip Code: 34982 Fax: 772-465-8448 Phone No. 772-633-0740 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: Brian.Pead@ame6gas.com State or County License: 02707/28579 if value of construction Is $2500 or more, a RECORDED Notice of Commencement is required. '' }� 7 AR 3i 7 ,, Tl+i, CS.33f s3kt� r, :tea DESIGNER ENGINEER. Not Applicable Name: MORTGAGE COMPANY: Name: ,Not Applicable Address: Address: City: Zip: State: Phone: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: X Not Applicable Name: BONDING COMPANY: Name: Address: Not Applicable 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 Coun makes no represert tion that is granting a permit will authorize the permit holder to build theist or prohibit structure structure. Please consult with yourbHome Owners Ass elation andrrevlew your deead r any resttrictions whichtmay apply lblt such Inconsideration 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 twice for im menu to your property. A Notice of Commencement must be recorded and posted on the jobsite fKore t firr�ect_on. If you intend to obtain finan . , c suit 11lti9�lender or an attorney before coMrnenciing,wWK ......F*STATEFLORaIDA signatur of Agent/ Lessee rctor/License Holder STATE O RIDA � COUNTY Ok Q COUNTY OF f �� The forgoing Instrument was acknowledged before me The forgoing instrument was acknowledged before me this-", day of 4> ]cam 20_LV by this 3 day of �c� 2015 by (Name of person ackno tedging (Name of person acknowledging) (Signature of Notary Public Sta a r-0 a ) (Signature of Notaryto of Florida j Personally Known � OR P Personally Known � OR Produced Identificati Persona Type of identification Produced O ., y efiof identification Produce ° v + Angela M Boore Commission NO.CyG t90 edh'commisslor,GG rec fa M Boore CO Inis510n No.Co�l90 Ba j mmssiorcc iwc::, Expires 02127f2022 Expires 02/2.712022 4". REVIEWS FRONT ZONING SUPERVISOR I PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014