HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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17! PECEIVEb
Nt APR 0�`2021 •
Sullding Permit APpl10Jon I rm rlt g d Merit
Plar3nir.�trtrcl DevetopntertCServices w � Luce county .;
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l3urlding and Code Regulutiort Division -ommerciar ReSICIGIItIaI
''300 lr rglnra A-'-' e'Fora Preece Ft J4982
Phone:(772)462=1553 Faz:(772)'462-1578`
PERRIIIT APPLICATION FOR Q
P.ROPOSED`IMPROVEM€NTlLOCATION: DOLL.AR`GENERAL '
Addr ess:,.375fi,VIRGINIA AVE,FORT PIERCE;FL 349 '1
Prop aka a a�-a��.�-ago
, ei Tax,iQ';fl
Lot`No:
Site-Plan Name; ;< Block No -;.
bAR ;z
Project Na GENERAL
me OLL
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.®ETAILED DESCRIPTIOIiI OF WORK:
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Inst6ll`12 Camera locations,Cats for cash•registerg and connect office equipment
,
New Electrical Meter. Second Electr,cal'Meter ,Li
CONSTRUCTION-INFO.RMATION._
A-�diionjl work to be performed under this permit:=che[k1'aIJ that apply
°Mthanical Gas-Tantc Gas Prying 'Shuttefrs "'`windows/Donis Pond_
t
w Electric Ptumbrng 5pr,nhters {[` ' F.Generator Roof Pitch
i ?otal Sq';Fi of Construction xSq Ft.of Frcst Floor
F'C;&Cof C,60structlon $ 100oAo 1200_:00 �tllme Sewed„ ,Septic Budding Height.
;OWiVEi /LESSt_E: ' .', sCONTRAt"TOR:
},f�ame'HSC FQRT,PIERCE LLQ'[ Y M E S tNEQEKERI Na hie. tillimm '(� Pac6
y
.,gddress:ISO BOX 1.30' Comanyy 'ower'Electric,Constructlon, Inc
e State: drys. = 5fi8 C;r711i _r'Id.
:Zip-Code:.', ,.Fax C,ty: Sf'/�ugustlne;'. State FL
251:=243 OZ08 3Z092
Phone No 'Zip'Code Fax.
E Mail:HAYMES@NIXSfVEDEKERCOM Phone No 904-6�6-1425
Fill in#ee simple Title Holder on next page(if different E ilrla l' Jg{ 6rJ8$I�II1� rT1SIl:COn1"
from ttie Owner listed above) 'State or County.License E;C-000994: .
If.value df construction is`21 0 or rnore,a ftEtUROED fUotice of Camrn6ricement rs;required,
;If value of HAVC is7,500 or•mare,a RECORDED Notice of Commencement Is required.
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SUPPLEMENTAL CONSTRUCTION,,LIEN,LAW INFORMATIO[ ,
DESIGNER/ENGINEER: -Not;Applicable MORTGAG COMPANY Not"Appljcable "
Name; Name;. . .
E
Address: Address. : ...
City: State: City:p
Phone,'
Zr
'S ate:-
. ,.. -;� Phone:
FEE SIMPLE TITLE HOLDEIt� Not Applicable = ; .SANDING CQMPANY Not Applicable
- _._
N
-. ' Name. - ,.,. -. ,, ,
Address: Address. ." i
Ctty:. Gty:
Phone
Zip-
.," .. . .:: .. Z�p�• . . , Phone
OWl`49R/-00NTRACf0R'AFFIDVIT:Application'is hereby'made to,"obtain a permrtto do the work and installation as indicated:
f;,C -if that_no fcl , stallation_has commenced pribr.-to the-issuance-o€-a-peimi -
St..Lucie Count ,makes no representation that is granting a permit wiIf authorise the permit holdertu build the subje_ctstructure
which is in conflict with any applicable Home owners Association rules,.bylaws ormand'covenants.that may restrict or.prohibit such"
sfructure..Please`consultwith your Home Owners Association'and review your.deed for any restrictions which may apply:
In consideratron'of-the granting.of-this recfuestecl-permit,I do'F ereby agree chat i`urtll,in all-respects,perform the v ork`
:in accordance with'the approved plans,the Florida Build Am
ing"Codes and St.Lucie.County endments.
4" The following building permit applications are exempt:from undergoing a full concurrency review:room additions; ,, "
accesso,rystructures .swimming pools,fences,%valls,.signs,screen rooms and accessory uses to another non residential use.
WARNING=TO:OWNER Your'failure to Recort3 a Notice of Commencement may result:i payingtwice-for
rm ro`Vements.to our roe p y p p rty.A Notice of Commencement must be recorded in the public records of St
l:"icie Cotanty and"posted'on the jotisite before the first inspection"If you-intendto,obtain financing, consult
' lender orari attorne before commencin work orr Ing our No 'cam' mencement:
'./�?� _
Si afore of Owner(Lessee(Contractor as Agent for Ovaner Signature of Contractor(Luense Holder:
STATE OFFLORIDA STATE OF AORIDA -
OUNTY'OF •St Johns COUNTY OF`y St Johns
Sworn to(or affirmed)and subscribed.before me of Sworn to(or affirmed)and subscribed before me of
)C "' Physical Presence or Online,Notarliati .."-Physical Pr'esenco:or .Online Notarization.
this 29th day of". March 2021 by 9 his 2,(�Jb da of �
^
.. ... -
PS O• Y ,,,_1I 2Cet1. 2.Q�>. _ bYr'" -:X S 1�N
X.
Jimmy, G'Pace Jimm :"G Pace
Name of person makJng statement: W 2.x15 ameof"persorf r'jki ' statement. o N"=
L N O -
"' ersonall Known X OR-Piotluced icienUf%atitz
peuonal(t+lCnown ORP oduced.ldentbfieat Ns —
Type of fdentifcation ,`, _� .t of ldentificaUon. ., E:
W=
Produced o Z o e rodu ed2,0
;
V ZZ
(Signature of Notary Publicr State of.Florida) a .. m v
HH,04.1177
�o (S��nawre of Notary„Pu.bhc State of Florida j
Commission No: (seal} 'r° sue' Commission No :HH 041177 .
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REVIEWS � FRONT -ZONING SUPERVISOR `PLANS VEGETATION SEA TURTLE, MANGROVE',-
COUNTER' `
;REVIEW .:,REVIEW . ' . .':REVIEW" REVIEW -'-`REVIEW .REVIEW
'DATE.•
RECEIVED
DATE,-
,,,
Td-51f Ta
,
COMPLETED