HomeMy WebLinkAboutBuilding Permit Application-signedAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
UWK6141111
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
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
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
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 INFORMATION:
Additional work to be performed under this permit —check all that apply:
Tank
_Mechanical
Electric
_Gas
Total Sq. Ft of Construction:
Plumbing
Cost of Construction: $ 250,000
Gas Piping
Sprinklers
_Shutters
_ Generator
ScFirst Floor:
_Windows/Doors
_ Ro
of
Utilities: _Sewer _Septic
Building Height:
Pitch
OWNER/LESSEE:
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: _
Zip Code: 32822 Fax:
Phone No. (407) 408-6177
Address: 1803 South 31st
Street
City: Ft, Pierce
Zip Code: 34947
Phone No (772) 468-3689
State: FL
Fax: (772) 464-5803
E-Mail: scott.kearney@wawa.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail mikez@wilsons-petroleum.com
State or County License
PCC045049
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:_
Address:
City:
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: _Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
MORTGAGE COMPANY:
Name:
Address:
CitV:
Zip: Phone:.
BONDING COMPANY:
Name:_
Address:
City:_
Phone:
Not Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 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 COMIqNCEMENT MUST E RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF Y 1 T O OBTAIN FIOANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y O ICE O C MMENCEM T_"
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sign at e Contractor/License Hol JeV
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF Stlucle
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of 20_ by
this 18Th day of January 20 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
Ld� I:t L;
(Signature of Notary Public- State of Florida)
(Signature of NotEWy Per lic- Sta
4CO% MARK SPIMEL
Commission No. (Seal)
Commission No. GG335007 a 4SONNISSION#G0335907
EXPIRES: May 16, 2023
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