HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: March 6, 2018 Permit Number: ,V f
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 x Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: 8613 & 8615 South US Highway 1, Port St Lucie, FL 34952
Legal Description: St Lucie Gardens 26 36 40 Blk 3 Part of Lots 12,13,1:4 and ;15 MPIDAF: Comm at NW
For Lot 13 Blk 3
Property Tax ID#: 3414-501-1912-500-6 Lot No. 12,13,14.-
Site Plan Name: Crowne Plaza
Block No.
Project Name: Pam's Fabric Nook
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
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Demolition of interior walls and flooring � �n
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Additionalwortoeeormeuner this permit—check a appy:
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Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator ❑_Roof Roof pitch
Total Sq. Ft of Construction: 3,000 Sq. Ft.of First Floor: 3;000
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, Cost ofConstruction:$ �> ��� Utilities: _Sewer Septic Building,,Height: 25Feet
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Name Crowne Lucie Associates Name: nomas Ie, e I er
8611 South Highway onstructi,on ManagementInc
Address: Company: i
City: Po Lucie State:_ Address: 1 Village reen rive
Zip Code: Fax: City: Port UCIe �; I State:
772-8�7-577T 34952 Phone No. Zip Code: 1; Fax: 72-237-30-ST
E-Mail:plaza crownecommercla .com Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: pau rmcorp .com
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER ENGINEER: T Not A licable COMPANY:! Not Applicable
/ pp MORTGAGE
Name:Crowne St Lucie Associates LP Name:
Address: Address: .I
City: State: City: i I State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ! ; Not Applicable
Name: Name:
Address: Address: I I
City: City: I' I
iZip: Phone: Zip: Phone: i
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.
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St.Lucie County makes no representation that is granting a permit will authorize the permit holde'r'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 concurrencyli,review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory usles to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in youripaying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
befor the first'ihspection. If you intend to obtain financing, consult with lender or''an attorney before
com*ipcing work or recording our Notice of Commencement
Signatre of Owner/Lessee/Contractor as Agent for Owner Signa re of Contractor/License Holders
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STATE F FLORIDA--, STATE OF FLORIDAI' i
COUNTY OF �/ �G cf a COUNTY OF
I The forgoing instrum t was knowledged before me The foXing instrum I as a k nowledged before me
this day of /' 20_If by this& day of (//' 20/�by
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Name of 1pers2pAking statement Name of paking'statement
Personally Known ers OR Produced Identification Personally Known l: OR Pr`nducedlIdentification
Type of Identification Type of Identification
Produced Produced
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i (Signature of aryPu c-State of Florida) (Signature of No PuGlic-S ate of Florida )
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Commission No. , �o (Seal) Commission No.�'�i�� o�0 (Seal)
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*,"'��•, s°�:' PAUL J AYNE
a,,, PAUL J PAYNE
REVIEWS �'_ 3QPAi@kon # i`SL�R\IS PLANS VEGE _Sf;l�TildRT�16n ;i MAIgiS V
W*EVtEttfl�lnissi n�ltK-W REVIEW REVI �E[-�/{€,pry�hmiss onREiV
DATE 'aiL����� ti
RECEIVED i
DATE j
COMPLETED I
Rev.8/2/17 1