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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: S0 '0/"�as,
W.PfF, 100m9em
COUNTY
___.. R
D._.______: 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 TYPE: Petroleum System -New Construction
PROPOSED'IMPROVEMENT LOCATION
Address: 121 S. Kings Highway, Fort Pierce, FL 34945
Property Tax ID #:
Site Plan Name:
Project Name: Wawa #5380 Fuel System
Lot No.
Block No.
DETALfD'DESCRIPTION OFWORK
Installation of petroleum storage and distribution system at a new c-store including the underground fuel storage tanks,
underground piping, dispensers, and all associated switches and sensors.
CONSTRUCTION INF0RMAT' ION
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 250,000 Utilities: —Sewer _Septic
-Windows/Doors
Roof Pitch
Building Height:
OWNER�L`ESSEE "=
CONTRACTOR.
�.
Name wawa Florida LLC (Scott Kearney)
Name: Michael D. Zarrella
Address: 7022 TPC Drive, Suite 200
Company: Wilson's Petroleum Equipment Inc.
City: Orlando, FL State: _
Address: 1803 South 31st Street
Zip Code: 32822 Fax:
City: Ft. Pierce State: FL
Phone No. (407) 408-6177
Zip Code: 34947 Fax: (772) 464-5803
Phone No (772) 468-3689
E-Mail: scott.kearney@wawa.com
Fill in fee simple Title Holder on next page (if different
E-Mail mikez@wilsons-petroleum.com
from the Owner listed above)
State or County License PCC045049
if value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPRtLEIVIENTAL CONSTRUCTION LIEN LAW, INFORMATION:
;. x
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
Stater
FEE SIMPLE TITLE HOLDER:
Name:
Address:
_ Not Applicable
BONDING COMPANY:
Name:
Address:
City:
Not Applicable
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 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 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 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 IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMKNCEMENT MUST §E RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF Y�1 I T O OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Yp ICE C MMENCEJp T."
JSIgnata
Signature of Owner/ Lessee/Contractor as Agent for Owner
Contractor/License Hol
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF Stlude
The forgoing instrument was acknowledged before me
this_ day of 20_ by
The forgoing instrument was acknowledged before me
this 18Th- day of January 20�Lj by
Michael D Zarrella
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known xxx OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced Personally Known
r
(Signature of Not Pu lic- Sta
(Signature of Notary Public- State of Florida)
Commission No. (Seal)
Commission No. *po-*+=W"SSION GG335007
REVIEWS
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ZONING
SUPERVISOR
PLANS
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SEA TURTLE
MANGROVE
COUNTER
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DATE
RECEIVED
DATE
COMPLETED
Rev. 277719