HomeMy WebLinkAboutBuilding Permit Application,' Y 1.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 1912-0056
II RIMMED,
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
MAR 1l 2020
Building Permit Application PermlttingDepartment
St. Lucie County
Commercial X Residential
PERMIT TYPE: Change of Occupancy
PROPOSED IMPROVEMENT LOCATION:
Address: 5053 TURNPIKE FEEDER RD
Property Tax ID p: 1301-615-0221-000-0
Site Plan Name: LAKEWOOD PARK -UNIT 12-A
Project Name: LIBERTY HEALTH SCIENCES
Lot No. '°'"•+zuexo,a�ass,
Block No. 179
DETAILED DESCRIPTION OF WORK:
CHANGE OF OCCUPANCY. NO CHANGES MADE TO STRUCTURAL, MECHANICAL, PLUMBING AND ELECTRICAL! ALL EXISTING REMAINED
PAINT ONLY
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 2175.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DFMMJ INVESTMENTS,LLC d.b.a. LIBERTY HEALTH SCIENCES FLORIDA
Address:18770 N COUNTY ROAD 225
Name: ROBERT KROUPA
Company: MCGREGORHOMES RENOVAnONS, INC. d.b.aMIONCONSTRUCTION COMPANY
City: GAINESVILLE, State: _
Zip Code: 33260 Fax:
Phone No. 786-942-8009
Address:1217 CAPE CORAL PKWY E.,
City: CAPE CORAL State: FL
Zip Code: 33904 Fax: 888-847-5242
Phone No 239-745-1115 DIRECT
E-Mail: Victor Mancebo / VMancebo@libertyhealthsciences.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail ADMIN@MCC-BUILD.COM
State or County License CGCA18522
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
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 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 COMMENCEMENT M ST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU IVrEND TO OBT IN FINANCING, CONSULT
WITH YOUR LEICDIR ORAN ATTORNEY BEFOREREC`j<'IRDING YOUR .N ICE OF COM NCEMENT."
Y, X�4 L_�
Sig?lure of 0 ner/ Lessee/Contracto as Agent for Owner
Signatureo(intr for/Liense Holcf r
STATE OF FLORIDA
STATERIDA
COUNTY OF LEE
COUNTY OF LEE
The forgoing instrument was acknowledged
The forgoing instrument was acknowledged 6
this 16TH day of MARCH 20 b •'.......... •.
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this 16TH da of MARCH 2O,76 '•"
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JASON CAMPAGNOLO %c99�
ROBERTKROUPA
Name of person making statement. "%",,,;,,,•'
Name of person making statement.
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Personally Known x OR Produced Iden
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Commission NO.G6 a� (Se I
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Rev.2///19