HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: Permit Number: 17 0\?;'C J
Building Permit Application
Planning and Development Services
Building and Code Regulation Division AUG ®9 2017
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial �_ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRQPOSED tIVIPROUEIUIENT LOCATIQN
Address:00, k 5
Legal Description:
Property Tax ID#: �( y d 0 ) — C)0 Q Q — 3 Lot No.
Site Plan Name: (( Block No.
Project Name: J K v r Pjr4
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
CONSTRUCTION INPORM'.,TION
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e n R
Additional work toa er orme under this permit—check a appy:
HVAC E]Gas Tank []Gas Piping Shutters Q Windows/Doors
QElectric ❑Plumbing ❑Sprinklers I Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ �j[ 7 Utilities:cn Sewer Septic Building Height:
GINNER/LESSEE CQNTRACTOR
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Name $/�N k V N 1'�ED Name: Arjka
Address: TOS M,E, ?r1Vnjj \JS--a $lv Company: I-II �/ G ✓i
City: {dor} 34. L.0 cf e State: FL. Address:_/Lp a VVI._/ 751- 41/e
Zip Code: _;L1983 Fax City: Birnrh► LOW State: �I
Phone No. Zip Code: 3301`O Fax:30 5 &J (949�1
E-Mail: Phone No. 0 5
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Fill in fee simple Title Holder on next page(if different E-Mail: U e w
_I Y1� lVL�Q.ln �1�tsV'i c.1 Vl f_ rH
from the Owner listed above) State or County License: Fz'ao0 i�Iyaa
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTA,'LCONSTRUCTION'LIENLAW INFORMATION:'
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 thepermit 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,Ido 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
impr5a'
ourroperty.A Notice of Commencement must be recorded and posted on the jobsite
befonm
on. If you intend to obtain financing, consult with lender or an attorney before
comcordin our Notice of Commencement.
S
4igenaktur-e see/Co as Agent for Owner Signature o ns6er
STATE OF FLORIDA STATE OF FLORIDA �1 ao
COUNTY OF�(i vn I - � �Q COUNTY OF Wfayyl i � 6 U�
The f rgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 I n by this IL day of 20 til-by
Na
(Name of person acknowledg ng) (Name-of person acknowl ging)
(Signature o tary Public-State of Florida) (Signatur o Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification P
•,J;��HY � STEPHANIE REY
,••atY a''•, S P IE REY +. ;: MY COM
T€ Commission No. �s FF 197971
Commission No. =�q' �1`�= MY C0 9SSI N#FF 197971 ..` EXPIRE e r ary10,2018
_..
:, EXPIRES:February 10,2019 p,';�4Q Bonded Thru Notary Public Underwrffers
'F' 'o`•' to PublicUndawilers
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
Work Order
' Golden Sands General Contractors Inc.
Order Date: 07/31/2017
2500 NW 39th Street,#104
Miami,FL 33142 Client Work Order:
NA
GOLDEN SANDS
GENERAL CONTRACTORS GS Client Work Order: 27050
1
Client: 2500 NW 39th Street,#104 Pro)ect: Service Site
Miami, FL 33142 BankUnited, FSB
GS Coordinator:Jessica Rosado Port St. Lucie Prima Vista
Phone:305.633.3336 905 E Prima Vista Blvd B-265
Port St. Lucie, FL 34952 US
Contact:Jessica Rosado
Phone:863.984.7500
Requested Date:7/31/2017 SLA Date:8/31/2017
Scope: General Carpentry
Please provide itemized pricing for the following scope.of work:
Price includes; hand dryer,wiring, breakers, permit, permit fee,testing, inspections
Air Flow: 130 CFM(Cubic Feet per Minute)
Air Velocity:4500 LFM(Linear Feet per Minute)
Temp Rise:60 degrees F
Dimensions: 10 1/8W x 9 3/8H x 5 5/8 D
Weight:Steel units: 10 lbs.,ABS: 8 lbs.
Motor: Permanently lubricated, maintenance-free, brushless induction
motor with automatic resetting thermal protector, 1/12 HP, 3100 RPM.
Tamper Resistance:Tamper resistant screws secure cover to base.
Air intake vents are shielded for additional safety.
Automatic Sensor: RoHS compliant lead-free design. Microprocessor
controlled infrared sensor turns dryer on when
hands are under the outlet for up to 80 seconds.
Heating Element: Constructed of Ni-Chrome resistance wire with automatic
resetting thermostat. Heating element operates in the black range for maximum life.
Test to ensure all is working proficiently.
Vendors-Please send your invoice to Your respective facility coordinator within 48 hours after iob completion.
Notes: 1.If additional work Is needed(that you do not provide)call Golden Sands IMMEDIATELY
2.Please make sure Job site Is left clean at the completion of your work.
3.Please call Golden Sands to notify of completion of the work order.
1 Golden Sands General Contractors Inc. Page 1 06/07/17 07:24:26 AM