HomeMy WebLinkAboutBuilding Permit Application I ,
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t, �t i�� 1 . J2- PcrmitNumtier. LI oa31
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RECEIVED
APR 0$ 2021
Bu iding Permit Applicatio.h
r�ermitdi g D'aprtmeht
Planning and beilelop'ment Servkes t. Lucie"Cau,rt}�,'
Suilding and Code Regulation Division corn ler ic3I YES " ReSldDntlal
Z30L Virginia Avenue, Fort Pierce FL 34982 ;
Phone:(772)4621553-Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: DOLLAR GENERAL
Address:.3751 VIRGINIIA AVE FORT PIERCE, FL 34981
Property Tax ID.#: �` 1 °�0� 4 � ^ 8�0 Lot No.
Site Plan Name: Block No:
Project Name: DOLLAR GENERAL
DETAILED DESCRIPTION OF WORK:
Install 12,Camera'locations,Cat 5 for cash;registers and connect office equipment
New Electrical Meter Second Electrical Meter -'
CONSTRUCTION INFORMATION:
A` 6fillb I work,to be performed under this permit:=check all that�aoply;'
(. ;PJferanicaF =Gas Tank . Gas Pipirig" " ;; ,3:`s'.Shottef s Windows/Doors Pond
4 - 4 £ , a
Eieairic- _Plumbing, -Sprinklers-, ,- Genetator Roof Pitch
4 S k +,
V
Total
,Sq` i of Construction: F't Ws tFloor
1200.000 Sewe Se_
tic Building Height:CotofCopstructlon:$ 1000.0 i �..
:OWNER,/LESSEE: i CONTRAUOR:.
k Plarne HSG FORT PIERCE:LLC[HAYMES SNEDEKER]. Name:
AddressO BOX 130Corn-a ,..-lower Electric Construction, Inc
$ �_. r
CiTy:'.DYtPHNE_` `State:_ rA�idFess-�: -588 Collier Rd
Zip Code:•36526 Fax: City: St Augustine, State: FL
Phone No.251;-243-0708 Zip Code: 32092- Fax: "
E-Mail:HAYMES@HIXSNEDEKER.COM phone No_904-626-1425
(-Fill in fee simple`ritle Holder on next page("if different E-Mail 1gp6588kmp@msn.COm
from the Owneir listed above) State or'County-License EC-0000994
if value of construction is 2500 dr more,a RECORDED Notice of Commencement is required..
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION:.. - '
DESIGNER/ENGINEER: ^Not Applicable MORTGAGE COMPANY: Not Applicable
Name; Name:
Address: Address:
City: State: City: State:
Zip: Phone 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.
_-1 certi that no%v-orkocinstallation_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 ofthe granting of this requested permit,I do thereby agree that i'iwill in all-respects,perform the work
in accordance with the approved plans,the Florida;Building Codes and St.Lucie County Amendments.
u 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 paying twice for '
improvements to your property.A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection-If you'intend to obtain financing, consult
lender or an attorney before comme' ncin work or recording our No e'of co,mrnencement.
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Sigaature of Owner/Lessee/Contractor as Agent fo f owner Signature of Contractor/License Holder '
STATE OF FLORIDA STATE OF FLORIDA i
COUNTY OF St Johns COUNTY OF 'St Johns
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
X Physical Presence or Online Notarizati Physical Presence.or .Online Notarization-
this 29th day of . March. 2021 by ^o his 2Qtlj day of March, 0 1 by. r^c
Jimmy G Pace Jimmy G Pace m a
Name of person making statement. W _ ame of person making statement.- ru
.2
<"r PersonallµlCnown X" OR:Produced.ldendficat SEA -ersonaliy_Known:—X' OR Produced identiticatiq V
a '
Type of Identification a E E t :of IdentificationE °^
Produced g z e rodu ed �
e <i T
}
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) - Y`
HH 0411.77: = HH 041177 =
Cortimission roo. (Seat).,. '1 Commission No,-
tSe,I
REVIEWS . FRONT ZONING SUPERVISOR` PLANS VEGETATION ,SEA TURTLE MANGROVE
COUNTER REVIEW. REVIEW . REVIEW" REVIEW - REVIEW `REVIEW. ;
DATE
RECEIVED
DATE . _ -
COMPLETED -
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