HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �}
Date: - (i "-1 `� Permit Number:` —B-I
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Building Permit Applicatio
Planning and Development Services IIl=C4O 9 7019 _
Building and Code Regulation Division
ST. IEkCrt3itti►agrt3 p C iemY_i^n
2300 Virginia Avenue, Fort Pierce FL 34982 t-taste Chanty^
Phone: (772) 462-1553 Fax: (772) 462-1578 COrnmercial Yes Residential
PERMIT APPLICATION FOR: Renovation
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Address: 8631 S. US1, Port St. Lucie, FL 34952
Legal Description: ST LUCIE GARDENS 263940 BLK3PARr OF LOTS 12.13.14 AND 15 MPDAF. COMM AT NWOOR LOTI3 BLK3STLUCIE GARDENS RUN"89412SWALG NLJ LOr121406Fr.T11 S273137 E 222.92 Fr.TH S272917E 111.94 Fr.TN N 63
Property Tax ID #: 3414-501-1912-500-6
Site Plan Name:
Project Name: Coast Spine Center
Setbacks Front Back: Right Side: Left Side:
Lot No.
Block No.
Tenant improvement, new walls to split space into offices, reception, storage, consult areas, add exit
signs, new doors, trim anad paint
1]HVAC Gas Tank
P] Electric 0 Plumbing
Total Sq. Ft of Construction: 1500
Cost of Construction: $ 11,000
unaer tnis permit — ci
E]Gas Piping
❑Sprinklers
a
UShutters ❑. Windows/Doors
0Generator E] Roof Roof pitch
S Ft. of First Floor: 21276
Utilities:Sewer Septic
Building Height: 38'-4"
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Name Crowne St Lucie Associates LP
Name: Jesus Medina
Address:1015 Financial Center
Company: Big Dog Repair LLC
City: Birmingham State:AL
Address:
Zip Code: 35203 Fax:
City: Fort Pierce State: FL
Phone No.561-603-4783
Zip Code: 34950 Fax:
E-Mail: plaza@crownecommercial.com
Phone No. 772-742-1200
Fill in fee simple Title Holder on next page (if different
E-Mail: bigdogserv@gmail.com
State or County License: CBC1253459
from the Owner listed above)
1T vdiue or construction is;czwu or more, a rctwnutu Notice of commencement is required.
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name: Big Dog Repair, LLC
Name:
Address:
Address: 130 S Indian River Or
City: Fort Pierce
State: FL
City:
State:
Zip:3a95o Phone772-742-1200
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
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 operty. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspectign. If you intend to obtain financing, consult with lender or an attorney before
commencing work or redd oordine vour Notice of Commencement.
Signatu46fner/ Les ee/ ontractor asAgent for Owner
Signature of Co tract /Li se HolderSTATRIDA
STATE OF LORIDACOUN:rl�" �
Lyc.,'Q
COUNTY OF Sc-�•�'lf Lc,4
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this Zsday of 20 V% by
this _. day of Jc•ti�.�ai�J 20 I4 by
.30—SuS
& 0,1 to L
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification to�
Personally Known OR Produced Identification
Type of Identification
Produced �el—vg D/Aloes C. GOyx<
Type of Iden 'f11cat(o
Produced V 9ca �N
ure of No u ic- State of Florida }
(Signature of Notary Public- State of Florida }
Commission No. (Seal)
Commission No. (Seal)
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i►$1" "fee,;,
JEFF EPSTEIN
,•°�►r"' "k%.,
JEFF EPSTEIN
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Rev. 8/2/17 1 1 0I �
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